Authors:

Abstract

Background: Acute mesenteric ischaemia (AMI) is the abrupt cessation of blood flow through the mesenteric arteries. It is the reported pathology in over 30% of patients undergoing nontraumatic emergency laparotomy and may be caused by atherosclerosis, atherothrombosis, arterial embolism, arterial dissection, or may occur in patients with shock (either with or without structurally normal arteries). As the population ages, AMI is becoming increasingly common and mortality rates remain unacceptably high. The 2016 NELA report suggests 30 and 90day mortality rates of 26% and 30% respectively, with only 26% of AMI patients alive one year later. Current guidelines acknowledge the deficit of high quality studies and so the evidence base for their recommendations is limited. By its nature, AMI is a crossspecialty disease (including vascular and gastrointestinal surgeons, noninterventional and interventional radiologists, physicians and critical care teams) but current guidelines remain specialityspecific, with no multidisciplinary consensus yet achieved.

Methods: We will undertake a prospective observational study to investigate the presentation, management and outcomes in patients with AMI. This study will be conducted by the Northwest Research Collaborative, managed by a multidisciplinary steering group and will recruit from hospitals nationwide. The aim is to prospectively gather high quality data from patients with AMI during a sixmonth to a oneyear period. Data defining clinical presentation, investigation, acute management, 30 day and 90 day mortality rates, morbidity, secondary management of survivors and 5year survival rates will be produced.

Conclusions: This dataset will provide highquality evidence as a basis for further study. We will assess how observed practices adhere to current guidelines, and we will identify opportunities to maximise the quality of patient care.