Mesenteric Ischemia in the Emergency Department: a Retrospective Multicenter Study

Study Overview
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Brief Summary
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Acute mesenteric ischemia is a life-threatening condition characterized by high mortality if unrecognized early. This multicenter retrospective observational study will review the emergency departments's (ED) notes of all patients discharged from hospital with a diagnosis of acute mesenteric ischemia in 2014-2015 comparing it with those admitted to the ED for abdominal pain in the same timeframe.

Detailed Description
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Acute mesenteric ischemia is a condition characterized by non-specific presentation (typical clinical presentation is considered abdominal pain out of proportion to examination) that may be under-recognized in the Emergency Department. Early identification and treatment is essential to improve outcome as mortality rate is attested around 80% if untreated within few hours from onset. The investigators aim to review the emergency department's clinical notes of patients discharged from hospital in 2014 and 2015 diagnosed with acute mesenteric ischemia. Furthermore the investigators will consider patients admitted for abdominal pain in the same time frame without acute mesenteric ischemia and we will compare presentation symptoms, medical history, medications, vitals, laboratory markers and imaging finding of the two groups. From this comparison, the investigators will be able to clarify the incidence among general population and among patients presenting acute abdominal pain. Finally, using multivariate analysis, the investigators may identify those variables predictive of acute mesenteric ischemia. This study will be held in three university hospitals and all data analyzed together.

Official Title
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Acute Mesenteric Ischemia in the Emergency Department: Incidence, Early Recognition and Risk Stratification From an Observational Multicenter Study

Conditions
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Acute Mesenteric Ischemia

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: ICD-9 diagnosis of acute mesenteric ischemia in 2014 and 2015 Admitted to hospital after Emergency Department assessment age>18 Exclusion Criteria: age<18 post-traumatic or post-surgery related acute mesenteric ischemia lack of assessment in the Emergency Department

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| acute mesenteric ischemia<br>patients with abdominal pain and acute mesenteric ischemia | |
| non-acute mesenteric ischemia<br>patients with abdominal pain without mesenteric ischemia | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| In-hospital mortality |  | 30 days from hospital admission | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| in-hospital adverse outcome: cardiac arrest, ICU admission, septic shock, major bleeding. |  | 30 days from hospital admission |