Clinical trial NCT02772913: Mesenteric Ischemia in the Emergency Department: a Retrospective Multicenter Study
Official title: Acute Mesenteric Ischemia in the Emergency Department: Incidence, Early Recognition and Risk Stratification From an Observational Multicenter Study
Study type: OBSERVATIONAL
Overall status: UNKNOWN
Conditions: Acute Mesenteric Ischemia
Lead sponsor: University of Genova
Sponsor class: OTHER
Collaborators: name: University of Bari
name: University of Siena
First posted: 2016-05-16
Enrollment: 500
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Observational model: COHORT
Time perspective: RETROSPECTIVE
Sampling method: NON_PROBABILITY_SAMPLE
Study population: Patients discharged from hospital with ICD-9 code related to acute mesenteric ischemia (1st cohort) compared with patients admitted for acute abdominal pain

Brief summary: 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: 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.

Eligibility criteria: 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

Primary outcomes:
measure: In-hospital mortality
timeFrame: 30 days from hospital admission
Secondary outcomes:
measure: in-hospital adverse outcome: cardiac arrest, ICU admission, septic shock, major bleeding.
timeFrame: 30 days from hospital admission
Other outcomes:
Locations:
city: Genova
country: Italy
facility: IRCCS San Martino
state: Liguria
Study officials:
affiliation: University of Genova
name: Vincenzo Savarino, Professor
role: STUDY_CHAIR
References: