Beumer, R. (Ruth) (2016) De incidentie en prevalentie van chronische mesenteriale ischemie. thesis, Medicine.
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Abstract
Background: Chronic mesenteric ischemia (CMI) is a relatively rare disease and there are no previous studies that report the exact incidence and prevalence. This study aims to analyze the incidence and prevalence in a well-defined area. For over the last twenty years this region has great attention to this disease and patients are referred here from over all the Netherlands. Therefore we expect the incidence to be found here will approximate reality. Also we describe the differences in clinical presentation and doctors-delay between patients inside and outside the catchment area of Medisch Spectrum Twente (MST). Methods: All patients diagnosed with CMI between 1997 and 2015 in MST were included. In these years the work up and diagnostic criteria remained the same. Patient records were collected prospectively. Contingent missing patients and data was collected retrospectively from medical files. Results: Because of the small number of patients, the annual incidence was averaged over four (first period six) consecutive years. The cumulative incidence of CMI between 1997- 2002, 2003-2006, 2007-2010 and 2011-2014 was 0.9, 2.0, 2.7 and 5.6/100,000 persons/year respectively. Even in the last period the incidence seemed to increase. The point prevalence on 31 December 2014 amounted to 32.0/100,000 persons. Clinical presentation between patients inside and outside the catchment area of MST differed at three levels. First acute on chronic mesenteric ischemia was found significantly more in patients outside the catchment area (3.1 vs. 8.4%, p-value = 0.04). Second these patients had a long duration of symptoms at time of diagnosis (in months 7.0 median (2.0-18.0 range) vs. 10.0 median (5.0-24.0 range), p-value = 0.003) and thirdly, more weight loss over the past twelve months (6.3 average ± 6.3 versus 8.8 average ± 7.9 kilogram, p-value <0.001). A difference in survival was not found. Conclusions: The incidence of CMI measured in this study appears to increase from 0.9 to 5.6/100,000 persons/years over the past two decades. Even the last years the incidence kept increasing. This seemed to be the effect of improvement in attention and diagnostics, rather than the reflection of a true increase in incidence. On 31 December 2014 the point prevalence of CMI was 32.0/100,000 persons. Patients outside the catchment area of MST were more likely of having imminent acute mesenteric ischemia, longer doctors-delay and more weight loss.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Begeleiders: and Kolkman, Prof. dr. JJ maag-darm-leverarts Medisch Spectrum T and Brusse-Keizer, Dr. MGJ klinisch epidemioloog Medisch Spectr and Locatie Afdeling maag-darm-leverziekten te Medisch Spectrum |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:47 |
| Last Modified: | 25 Jun 2020 10:47 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/826 |
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