One-year survival and quality of life after acute mesenteric ischemia: Follow-up of the AMESI study.

BACKGROUND

There is a lack of data regarding contemporary 1-year survival and quality of life (QoL) of patients after hospital treatment for acute mesenteric ischemia (AMI). We aimed to assess the 1-year survival and QoL and analyze their predictors in patients leaving hospital alive after an AMI episode.

METHODS

Follow-up of an international multicenter prospective study of AMI. For patients discharged alive from hospital, demographic data, data on preexisting comorbidities and disability, 1-year survival, presence of stoma and ongoing parenteral nutrition (PN) at hospital discharge and at 1 year, and QoL at 1 year assessed with EQ-5D-5L were collected. Baseline comorbidities, discharge status, and sequelae of surgical treatment as potential risk factors for mortality were analyzed with Cox proportional hazards and for lower QoL with negative binomial models.

RESULTS

One-year survival was 161 of 198 (81.3%). There were no differences in survival between different AMI subtypes. Forty-six percent of patients reported no problems in any of the EQ-5D-5L dimensions; no patient had extreme problems in all dimensions. The median (interquartile range) of patient self-reported QoL visual analog scales (VAS 100) was 75 (50-85). Age-adjusted Charlson comorbidity index at index hospitalization was the only independent risk factor for mortality, with hazard ratio (95% confidence interval) of 1.24 (1.08-1.42). Risk factors for lower QoL were age-adjusted Charlson comorbidity index, disability, and need for PN at 1 year, with risk ratios (95% confidence interval) of 1.10 (1.06-1.13), 1.33 (1.03-1.71), and 1.61 (1.13-2.27), respectively.

CONCLUSION

After successful treatment of an AMI episode, most patients survive for 1 year and have satisfactory QoL. Survival after hospital discharge is not different for different AMI subtypes. Survival and QoL are negatively influenced mostly by comorbidities, with effects similar to those of any other disease group. QoL is also influenced by prior disability. From AMI specific aspects, need for PN at 1 year has a negative impact on QoL.

LEVEL OF EVIDENCE: Prognostic and Epidemiological; Level IV.