Influence of splanchnic artery stenosis on the in-hospital clinical course of elderly patients.
BACKGROUND
Chronic mesenteric ischaemia (CMI) has a long asymptomatic period, but little is known about the clinical implications of this phase of the disease, particularly in the elderly, who are most exposed to the condition.


OBJECTIVE
The aim of the present observational study was to survey the in-hospital clinical course of elderly patients during the non-specific phase of the disease due to occlusion of at least one splanchnic artery.


METHODS
For a median of 29 months, we followed up 85 patients aged 65 and over who, for various clinical reasons, had undergone computed tomographic and magnetic resonance angiography during 2010 at Padua Teaching Hospital, assessing economic impact and reasons for admission.


RESULTS
Thirty-four of these patients had at least one occluded artery, and 68 % of them had at least one hospital admission. Elderly CMI patients were characterised by a higher number of admissions (median 2 vs 1 p = 0.05) and a higher cost (6044 vs 1733 Euros p = 0.04), but did not present typical gastrointestinal symptoms. The higher number of hospital admissions was not due to specific clinical risks (admitting wards: general medicine: 32 vs 29 %, p = 0.77; general surgery 8 vs 14 %, p = 0.73; vascular surgery: 26.5 vs 20 %, p = 0.46).


CONCLUSIONS
In the asymptomatic phase of CMI, hospitalised elderly patients with at least one occluded splanchnic artery can be subject to a more challenging in-hospital clinical course.
Simple Operational Unit of Surgical Endoscopy, Department of Surgical and Gastroenterological Sciences, General and University Hospital of Padua, Via Giustiniani, 2, 35100, Padua, Italy. fabrizio.cardin@sanita.padova.it.
Fabrizio
F
Cardin
Clinical Geriatrics Unit, Department of Internal Medicine, University of Padua, Padua, Italy.
Stefania
S
Fratta
Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy.
Egle
E
Perissinotto
Surgical Unit, "Villa Maria" Clinic, Padua, Italy.
Carmelo
C
Militello
Complex Operational Unit of General Surgery, General and University Hospital of Padua, Padua, Italy.
Bruno
B
Martella
D000368:Aged; D000072226:Computed Tomography Angiography / Q000379:methods; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007558:Italy; D008137:Longitudinal Studies; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D065666:Mesenteric Ischemia / Q000175:diagnosis / Q000503:physiopathology; D010043:Outcome and Process Assessment, Health Care; D013152:Splanchnic Circulation
Chronic mesenteric ischaemia; Elderly; In-hospital clinical course; Symptoms