Trends in population-based incidence and mortality of acute superior mesenteric artery occlusion

Abstract Acute occlusion of the superior mesenteric artery (SMA) results in lethal intestinal ischaemia. Results from two previous population-based studies in Malmö, Sweden, suggest a decreasing incidence of acute SMA occlusion. The study aim was to evaluate trends of the epidemiology of acute SMA occlusion in Malmö. The report was a retrospective population-based study during 2014–2019 on patients with acute SMA occlusion residing in Malmö municipality. Patients were retrieved from Skåne University Hospital and post-mortem examinations. Epidemiological data was compared to the 2000–2006 study. Sixteen patients with acute SMA occlusion resided in Malmö municipality. The incidence of acute SMA occlusion significantly decreased from 5.4/100,000 person-years to 0.8/100,000 person-years. The ratio of acute SMA occlusion to non-occlusive mesenteric ischaemia (NOMI) decreased from 12.5:1 to 0.9:1 (p < 0.0001), the proportion of inhabitants aged 80 or above in the population decreased from 6.0–4.3% (p < 0.0001), and the autopsy rates decreased from 25–14% (p < 0.0001). In-hospital mortality decreased from 63–44% (p = 0.14). The incidence of acute SMA occlusion significantly decreased in Malmö probably due to high-resolution computed tomography angiographies around-the-clock distinguishing acute SMA occlusion from NOMI, lowered share of elderlies, improved medical risk factor control, and lowered autopsy rate.