What Is Acute Mesenteric Ischemia (AMI)?

Acute mesenteric ischemia (AMI) mostly affects the elderly population and is caused by poor blood flow in the bowel, which leads to inflammation, pain, infection, and permanent damage. Parts of the bowel can die, becoming gangrenous and resulting in a life-threatening situation. Usually, emergency surgery is required, but successful recovery is difficult to predict and many people do not survive long after surgery.

What Is Quality of Life?

Quality of life (QoL) is a term used to describe a person’s satisfaction with their life. Each person views different life aspects positively and negatively. Examples of areas that can affect QoL are physical and psychological health, productivity, spirituality, independence, and relationships.

Measuring QoL is a very common way to understand how a disease or treatment affects a person, and can be used to guide decisions about a treatment. A high QoL score means that a person experiences a high QoL.

Until now, QoL for people who have had AMI and survived up to 4 years after surgery has not been investigated.

How Might Quality of Life Be Affected for a Survivor of Acute Mesenteric Ischemia?

After surgery for AMI, a person may not be able to eat or digest food. They may need to be “fed” through a tube connected to a vein, or they may have had a stoma fitted, which is a tube leading from the stomach or bowel to a waste collection bag outside the body. The researchers thought that these changes might result in lower QoL for long-term survivors.

How Did the Researchers Investigate Their Idea?

Quality of life can be measured in various ways. In this paper the authors used a questionnaire called the EQ-5D, to assess QoL in long-term survivors of AMI. There were questions on mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. The scoring system is designed to reflect a person’s age and gender, particularly important since the people they assessed were in the elderly range, the typical age range for AMI.

Then, the researchers compared the survivors’ scores with the scores from people with a similar life situation but who had not had AMI.

Finally, rather than just look at QoL after survival, the authors took a step further. They also looked at health problems the patients had prior to becoming ill with AMI such as diabetes, heart and kidney problems, or use of medicines such as blood thinners. They used statistical methods to assess if there was a connection between these preexisting health problems and the level of QoL.

What Did This Study Show?

It is the first time that information on QoL for survivors of AMI up to 4 years after surgery has been reported.

• Firstly, the researchers found that long-term survivors did have a lower QoL score than people with a similar life situation but who have not had AMI. However, this was for different reasons than what the researchers expected. The lower QoL could not have been due to complications because none of the long-term survivors had these complications.
• Secondly, the researchers found that long-term survivors had fewer preexisting health problems than those who did not survive.

The researchers connected these two findings to conclude that survival and long-term QoL is affected by a combination of preexisting health problems rather than one single factor such as age or post-surgery complications.

Take-Home Message

When making treatment decisions for AMI and informing about the possible outcome, a person’s preexisting health should be considered an important factor affecting survival and QoL after recovery.