title: Trends in Treatment and Mortality for Mesenteric Ischemia in the United States from 2000 to 2012.
abstract: BACKGROUND
  It is unknown whether increased endovascular treatment of chronic mesenteric ischemia has led to decreases in open surgery, acute mesenteric ischemia, or overall mortality. The present study evaluates the trends in endovascular and open treatment over time for chronic and acute mesenteric ischemia.
  
  
  METHODS
  We identified patients with chronic or acute mesenteric ischemia in the Nationwide Inpatient Sample and Center for Disease Control and Prevention database from 2000 to 2012. Trends in revascularization, mortality, and total deaths were evaluated over time. Data were adjusted to account for population growth.
  
  
  RESULTS
  There were 14,810 revascularizations for chronic mesenteric ischemia (10,453 endovascular and 4,358 open) and 11,294 revascularizations for acute mesenteric ischemia (4,983 endovascular and 6,311 open). Endovascular treatment increased for both chronic (0.6-4.5/million, P < 0.01) and acute mesenteric ischemia (0.6-1.8/million, P < 0.01). However, concurrent declines in open surgery did not occur (chronic: 1-1.1/million, acute: 1.8-1.7/million). Among patients with acute mesenteric ischemia, the proportion with atrial fibrillation (18%) and frequency of embolectomy (1/million per year) remained stable. In-hospital mortality rates decreased for both endovascular (chronic: 8-3%, P < 0.01; acute: 28-17%, P < 0.01) and open treatment (chronic: 21-9%, P < 0.01; acute: 40-25%, P < 0.01). Annual population-based mortality remained stable for chronic mesenteric ischemia (0.7-0.6 deaths per million/year), but decreased for acute mesenteric ischemia (12.9-5.3 deaths per million/year, P < 0.01).
  
  
  CONCLUSIONS
  Population mortality from acute mesenteric ischemia declined from 2000 to 2012, correlated with dramatic increases in endovascular intervention for chronic mesenteric ischemia, and in spite of a stable rate of embolization. However, open surgery for both chronic and acute ischemia remained stable.
authors.affiliation: Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Boston, MA.
authors.forename: Sara L
authors.initials: SL
authors.lastname: Zettervall
authors.affiliation: Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Boston, MA.
authors.forename: Ruby C
authors.initials: RC
authors.lastname: Lo
authors.affiliation: Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Boston, MA.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Soden
authors.affiliation: Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Boston, MA.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Deery
authors.affiliation: Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Boston, MA.
authors.forename: Klaas H
authors.initials: KH
authors.lastname: Ultee
authors.affiliation: Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, MA.
authors.forename: Duane S
authors.initials: DS
authors.lastname: Pinto
authors.affiliation: Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Boston, MA.
authors.forename: Mark C
authors.initials: MC
authors.lastname: Wyers
authors.affiliation: Division of Vascular and Endovascular Surgery, Beth Israel Deaconess Medical Center, Boston, MA. Electronic address: mscherm@bidmc.harvard.edu.
authors.forename: Marc L
authors.initials: ML
authors.lastname: Schermerhorn
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D016208:Databases, Factual; D017128:Embolectomy / Q000639:trends; D004621:Embolization, Therapeutic / Q000639:trends; D004691:Endarterectomy / Q000639:trends; D057510:Endovascular Procedures / Q000009:adverse effects / Q000401:mortality / Q000639:trends*; D005260:Female; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D008297:Male; D065666:Mesenteric Ischemia / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D008641:Mesenteric Vascular Occlusion / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000639:trends*; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D058017:Vascular Grafting / Q000639:trends; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000401:mortality / Q000639:trends*