Clinical correlation of mesenteric vascular disease in older patients

Mesenteric vascular obstruction is dif- ficult to characterize, since it may produce differing acute or chronic clinical pictures and various or- ganic symptoms, such as ischemic colitis and ab- dominal angina. The diagnosis of chronic mesen- teric ischemia (CMI) is thus still mainly based on historic diagnostic criteria drawn up before non-in- vasive radiological imaging of the mesenteric vessels became widespread, and before the current demo- graphic developments leading to a rise in the number of older patients with multiple pathologies. With this premise, we studied the clinical condition of 85 patients aged over 65 years of age, submitted to angio-CT scan for reasons other than neoplastic and general pathologies which may cause alterations in mesenteric blood flow, and without the typical symptoms of acute intestinal ischemia. Of these, 34 patients presented occlusion of at least one mesenteric vessel and 13 were affected by multi- vessel injury. Compared with controls, patients with mesenteric artery disease had lower BMI (24.9±3.3 vs 26.8±4.5) and longer hospital stays (14 vs 6 days), and were more frequently affected by vascu- lopathies in other districts (97.1% vs 80.4%), but the only bowel symptom present was diarrhea (21.2% vs 5.9%). These patients also took more benzodi- azepines and acetylsalicylic acid. The results of step- wise logistic analysis of length of hospital stay, vas- culopathies, diarrhea, and use of benzodiazepines yielded a predictive model with an AUC (area under the curve) of 0.81. Our data show that some features characterizing CMI in the geriatric population differ from those of the general population.