Quality of life temporarily improved in patients in whom the diagnosis chronic mesenteric ischemia wasn’t confirmed after multidisciplinary evaluation in a tertiary referral centre

Objectives: Chronic Mesenteric Ischemia (CMI) is a disease in which abdominal symptoms are caused by insufficient mesenteric blood supply. Treatment results in improved quality of life (QoL). To put these results into perspective, the QoL of patients with symptoms potentially complying with CMI but without confirmation of the diagnosis was studied from six months up to four years.Methods: Between May and July 2020 follow-up questionnaires were sent to 144 patients that were suspected of CMI but in whom the diagnosis was not confirmed after a thorough multidisciplinary evaluation in a CMI expert centre. The baseline QoL was measured at first presentation. Three cohorts were included: 50 patients with a follow-up of six months, 45 patients with a follow-up of two years, and 49 patients with a follow-up of four years were invited to participate. The QoL was measured on a 100 points Visual Analogue Scale (VAS). A minimal clinically important difference of 7.5 was used as non-inferiority threshold.Results: The response rates were 34/50 (68%), 33/45 (73%), and 34/49 (69%). QoL improved in the six months group, with a mean change of 19 in VAS score (95% CI 11-27), in which baseline QoL was inferior to the QoL at follow-up (lower bound 95% CI above >7.5 threshold). The change in QoL was inconclusive in the other two groups, respectively 15 (95% CI 6-24) and 3 (95% CI -6-13). Furthermore, there was no significant change in QoL between patients without mesenteric stenosis and with one or two vessel stenosis (P=0.36) and between patients with occlusive stenosis and anatomic Median Arcuate Ligament Syndrome (MALS) (P=0.53).Conclusion: The QoL of patients suspected for CMI was clinically significantly improved after six months without additional treatment. However, this improvement faded completely after four years.