Background: There are no clinical or laboratory markers that can diagnose acute mesenteric ischemia (AMI) accurately. This study aimed to find differences in clinical and laboratory markers between arterial occlusive AMI and other acute abdominal diseases where AMI was initially suspected. Methods: This was a post hoc study of an international prospective multicenter study where data on patients with suspected AMI were collected. Independent factors associated with arterial occlusive AMI were evaluated in a multivariable logistic regression analysis. Results: The number of patients with arterial occlusive AMI was 231, consisting of thrombotic (n = 104), embolic (n = 61), and indeterminate (n = 66) occlusions. The non-AMI group included 287 patients, of whom 128 had strangulated bowel obstruction. Current smoking (odds ratio [OR] 2.56, 95% confidence interval [CI] 1.31–5.03), hypertension (OR 2.08, 95% CI 1.09–3.97), bowel emptying (OR 3.25, 95% CI 1.59–6.63), and leukocytosis (OR 1.54, 95% CI 1.14–2.08) at admission were independently associated with arterial occlusive AMI compared to the non-AMI group. Conclusions: This study found clinical and laboratory data to be associated with arterial occlusive AMI in patients with suspicion of AMI, which can possibly be of value in screening for arterial occlusive AMI at the emergency department. Further studies are needed to find more accurate diagnostic markers.

Acute occlusion of the superior mesenteric artery (SMA) results in lethal intestinal ischemia. Results from two previous population-based studies in Malmö, Sweden, suggest a decreasing incidence of acute SMA occlusion. This study aimed to evaluate trends in the epidemiology of acute SMA occlusion in Malmö. The report was a retrospective population-based study conducted from 2014 to 2019 on patients with acute SMA occlusion residing in Malmö municipality. Patient data were retrieved from Skåne University Hospital and postmortem examinations. Epidemiological data were compared to those of the two earlier studies, in particular to the one conducted from 2000 to 2006. Sixteen patients with acute SMA occlusion resided in Malmö municipality. The incidence of acute SMA occlusion significantly decreased from 5.4/100,000 person-years to 0.8/100,000 person-years. The ratio of acute SMA occlusion to non-occlusive mesenteric ischemia (NOMI) decreased from 12.5:1 to 0.9:1 (p < 0.0001), the proportion of inhabitants aged 80 years or above in the population decreased from 6.0% to 4.3% (p < 0.0001), and the autopsy rate decreased from 25% to 14% (p < 0.0001). The in-hospital mortality rate decreased from 63% to 44% (p = 0.14). The incidence of acute SMA occlusion seems to have decreased significantly in Malmö, probably due to high-resolution computed tomography angiographies being available around the clock to distinguish acute SMA occlusion from NOMI, a reduced proportion of elderly individuals, improved control of medical risk factors, and a decrease in autopsy rates.

Background/Objectives: Acute mesenteric ischemia (AMI) is life-threatening and difficult to diagnose in time. Unlike many cardiovascular diseases, the association between lifestyle factors such as diet, alcohol consumption, and physical activity and AMI is unknown. Methods: This study is a prospective cohort study with 28,098 middle-aged participants with a mean follow-up time of 23.1 years. Baseline characteristics were obtained with questionnaires regarding physical activity, lifestyle, and diet. The primary endpoint was a diagnosis of AMI identified through the Swedish National Patient Register. Follow-up times were decided by the date of diagnosis, death, or end of follow-up, 2022-12-31. Results: The total number of patients with AMI was 140. Current smoking (adjusted hazard ratio [aHR] 3.02, 95% confidence interval [CI] 1.91–4.79) and those with the highest alcohol consumption (aHR 2.53, 95% CI 1.27–5.03) had a higher risk of developing AMI. Participants with high physical activity, 25.1–50.0 metabolic equivalent task hours per week (MET-h/week), had a lower risk (aHR 0.51, 95% CI 0.27–0.95). Diet quality and dietary components did not affect the risk of AMI. Conclusions: Smoking and higher alcohol consumption were associated with higher risk, while physical activity was associated with lower risk of AMI in this prospective cohort. Diet quality and dietary components were less relevant for the prediction of AMI than these traditional risk factors of atherosclerotic disease.

Background: Hypertension and smoking are well-known risk factors for aortic dissection (AD), but it is unclear whether other lifestyle factors influence the risk. The aim of this study was to investigate the association between diet quality, physical activity, and risk of AD. Methods: The study included 28,094 participants from the Malmö Diet and Cancer Study, recruited between 1991 and 1996 and followed through national health registers until 31 December 2022. Diet quality was assessed using a six-component Diet Quality Index. Incident AD was identified through ICD-9/ICD-10 codes in the Swedish National Patient Register. Associations were analyzed using Cox proportional hazards models. Results: During a median follow-up of 26.6 years, 130 participants developed AD. Higher age (HR 1.76/one standard deviation increment, 95% CI 1.41–2.20), male sex (HR 1.58, 95% CI 1.06–2.34), hypertension (HR 1.57, 95% CI 1.01–2.44), and current smoking (HR 3.04, 95% CI 1.86–4.98) were each independently associated with increased AD risk. No significant associations were found for diet quality and physical activity with AD risk. Conclusions: No associations were found between diet quality and physical activity and AD risk. Blood pressure control and smoking cessation are key preventive measures to reduce incidence of AD.

Background: Acute mesenteric ischaemia (AMI) includes acute superior mesenteric artery (SMA) thrombosis and embolism, venous AMI, and non-occlusive mesenteric ischaemia (NOMI). Patients with AMI are identified using the International Classification of Diseases (tenth revision (ICD-10)) code K55.0 (acute vascular disorders of the intestine). Reporting of outcomes depends on reliable case identification. Methods: A retrospective review of all patients assigned with ICD-10 code K55.0 at a tertiary university hospital between 1st January 2023 and 31st December 2025 was performed. Medical records and imaging findings were scrutinized to validate the diagnosis. Results: Among 218 patients assigned ICD-10 code K55.0, 117 (53.7%) had confirmed AMI and 198 (90.8%) had acute gastrointestinal ischaemia. Patients with NOMI (n = 30, 53.3%) had a higher bowel resection rate than patients with embolic SMA occlusion (n = 21, 23.8%; p = 0.039) or venous AMI (n = 15, 6.7%; p = 0.012). The in-hospital mortality rate was lower in patients with venous AMI (6.7%) than in patients with NOMI (66.7%; p < 0.003) or thromboembolic SMA occlusion (42.9%; p = 0.015). Conclusions: The positive predictive value for AMI using ICD-10 code K55.0 was 53.7%, underscoring the need for validated case identification. The heterogeneity of diagnoses captured by this code supports consideration of a more granular ICD coding system. A conceptual proposal is presented for further discussion and validation.