Incidence, diagnosis, therapy, and prognosis of acute mesenteric ischaemia, AMESI Study reveals

Recently published multicentre prospective observational study was conducted to investigate the incidence, patient characteristics, diagnostic pathway, management, and outcome of acute mesenteric ischaemia (AMI). The study included adult patients with clinical suspicion of AMI admitted or transferred to 32 participating hospitals worldwide. It was found that AMI occurred in 0.038% of adult admissions in participating acute care hospitals, with a total of 705 included patients, of which 418 patients had confirmed AMI. The study revealed that occlusive arterial AMI was the most common type diagnosed, followed by venous AMI and non-occlusive AMI (NOMI).

Management and Outcome of Acute Mesenteric Ischaemia (AMI)

In 69% of cases, AMI was the primary reason for hospital admission, and in 31% of cases, AMI occurred after being admitted with another diagnosis. The median time from onset of symptoms to hospital admission was 24 hours, and the time from admission to diagnosis was 6 hours. Initial management involved surgery in 58% of patients, with 24.4% undergoing revascularization. The overall in-hospital and 90-day mortality rates for AMI were 49% and 53.3%, respectively, with the highest mortality seen in the NOMI subtype (72.7% and 74.5%).

Variability and Need for Standardization in Management of Acute Mesenteric Ischaemia (AMI)

The study also highlighted the variability between participating sites for most variables studied, indicating a lack of standardized management internationally. Furthermore, the findings suggest a need for greater awareness of AMI, better guidance in diagnosis and management, and emphasize the importance of computed tomography angiography and immediate surgical treatment in patients with suspected AMI. The study provided valuable insights into the incidence, characteristics, diagnostic pathways, management, and outcomes of AMI, but also highlighted the need for further research and consensus processes to improve the understanding and management of this condition.

Reference –

Reintam Blaser, A., Mändul, M., Björck, M. et al. Incidence, diagnosis, management and outcome of acute mesenteric ischaemia: a prospective, multicentre observational study (AMESI Study). Crit Care 28, 32 (2024). https://doi.org/10.1186/s13054-024-04807-4