Mats Ögren

Fatal nonocclusive mesenteric ischaemia: population-based incidence and risk factors

Objectives.  To estimate the incidence and extension of visceral organ infarction, and to evaluate potential causes, in patients with autopsy‐verified nonocclusive mesenteric ischaemia (NOMI) and transmural intestinal infarction.

Incidence and risk of venous thromboembolism in patients with verified arterial thrombosis: a population study based on 23 796 consecutive autopsies

Summary.  Background: The relationship between atherothrombotic disease and venous thromboembolism (VTE) remains unclear. Patients and methods: In a cohort of 23 796 consecutive autopsies, performed using a standardized procedure and representing 84% of all in‐hospital deaths between 1970 and 1982 in an urban Swedish population, we investigated the relationship between verified arterial thrombosis and VTE, with the hypothesis that patients with thrombosis in major artery segments have increased odds of VTE. Results: We found an increased risk of VTE in patients with arterial thrombosis (Odds ratio; OR adjusted for gender and age 1.4, 95% confidence interval; CI 1.3–1.5) (P < 0.001). Patients with cervico‐cranial and peripheral artery thrombosis had an excess risk even when controlling for age and major concomitant diseases. A negative association between coronary thrombosis and VTE in the univariate analysis (OR 0.7; 95% CI 0.6–0.8) (P < 0.001), was less pronounced in the multivariate analysis (OR 0.8; 95% CI 0.7–1.0) (P = 0.016). Conclusions: A positive association between atherothrombosis and VTE was confirmed, except in patients with coronary thrombosis, where IHD as competing death cause is a possible confounder. Our findings indicate a potential for directed prevention, but may also imply similarities in etiology.

Low pulse-wave amplitude during reactive leg hyperaemia: an independent, early marker for ischaemic heart disease and death Results from the 21-year follow-up of the prospective cohort study ‘Men born in 1914’, Malmö, Sweden

Abstract. Objective. To study the incidence of myocardial infarction, all‐cause mortality and mortality from ischaemic heart disease in relation to arterial leg blood flow determined by venous occlusion plethysmography of the calf.

Fatal colonic ischaemia: A population-based study.

Objectives. To estimate the incidence of fatal colonic ischaemia (CI) and the cause-specific mortality of CI, and to describe the localization and extension of colonic infarction and quantify the risk factors associated with CI. Material and methods. Between 1970 and 1982 the autopsy rate in Malmö, Sweden, was 87%, creating the possibilities for a population-based study. Out of 23,446 clinical autopsies, 997 cases were coded for intestinal ischaemia in a database. In addition, 7569 forensic autopsy protocols were analysed. In a case-control study nested in the clinical autopsy cohort, four CI-free controls, matched for gender, age at death and year of death, were identified for each fatal CI case in order to evaluate the risk factors. Results. The cause-specific mortality ratio was 1.7/1000 autopsies. The overall incidence of autopsy-verified fatal CI was 1.7/100,000 person years, increasing with age up to 23/100,000 person years in octogenarians. Fatal cardiac failure (odds ratio (OR) 5.2), fatal valvular disease (OR 4.3), previous stroke (OR 2.5) and recent surgery (OR 3.4) were risk factors for fatal CI. Narrowing/occlusion of the inferior mesenteric artery (IMA) at the aortic origin was present in 68% of the patients. The most common segments affected by transmural infarctions were the sigmoid (83%) and the descending (77%) colon. Conclusions. Heart failure, atherosclerotic occlusion/stenoses of the IMA and recent surgery were the main risk factors causing colonic hypoperfusion and infarction. Segments of transmural infarctions were observed within the left colon in 94% of the patients. Awareness of the diagnosis and its associated cardiac comorbidities might help to improve survival.

High incidence of concomitant venous thromboembolism in patients with portal vein thrombosis: a population study based on 23 796 consecutive autopsies

High incidence of concomitant venous thromboembolism in patients with portal vein thrombosis : a population study based on 23 796 consecutive autopsies

High incidence of vascular reconstructions in socioeconomically deprived areas of an urban Swedish population

In Malmö approximately 250 000 citizens live in 17 administrative areas with substantial socioeconomic differences. At the single centre for arterial reconstruction, Malmö University Hospital, all procedures are registered prospectively.