Acute vascular insufficiency of intestine: incidence highest in summer, outcomes worst in winter

  • Asad JehangirEmail author
  • Rashmi Dhital
  • Anam Qureshi
  • Eugene P. York
Original Article



The incidence of acute vascular insufficiency of intestine (AVII) is on the rise in the USA and is associated with significant morbidity and mortality. Seasonal variations have been observed in the onset of several gastrointestinal diseases. It is thus far unknown whether the incidence, in-hospital mortality rates, and length of hospital stay (LOS) of AVII vary in different seasons.


The aims of this study were to study the seasonal variations in the (1) incidence, (2) in-hospital mortality, and (3) LOS of AVII in the USA.


We used the Nationwide Inpatient Sample to identify patients aged ≥ 18 years hospitalized from the years 2000–2014. We used the Edwards recognition with estimation of cyclic trend method to study the seasonal variation of AVII hospitalizations and z test to compare the seasonal incidences (peak-to-low ratio), mortalities, and LOS.


A total of 1,441,447 patients were hospitalized with AVII (0.3% of all hospitalizations). Patients with AVII were older (69.0 ± 0.1 vs 56.9 ± 0.1) and more commonly females (65.4% vs 35.5%) than patients without AVII (p < 0.001). The incidence of AVII increased through the summer to peak in September (peak/low ratio 1.028, 95% CI 1.024–1.033, p < 0.001). Patients with AVII hospitalized in winter had the highest mortality (17.3%, p < 0.001) and LOS (9.2 ± 0.7 days, p < 0.001).


The incidence of AVII in the USA peaks in late summer. The in-hospital mortality rates and LOS associated with AVII are the highest in winter. Physicians could be cognizant of the seasonal variations in the incidence, in-hospital mortality, and LOS of AVII.


Vascular insufficiency Intestine Incidence Mortality Seasonal 


Authors’ contributions

Asad Jehangir helped in the study planning, data interpretation, literature review, and writing the manuscript. Rashmi Dhital helped in data collection, statistical analysis, and writing the manuscript. Anam Qureshi helped in the literature review and writing the manuscript. Eugene P. York planned the study and did literature review and critical revision of the manuscript for important intellectual content. All the authors approve the final version of the manuscript.

An abstract of this study was presented at the Digestive Disease Week® at the San Diego Convention Center, San Diego, CA, on May 21, 2019 and nominated as the Poster of Distinction.

Compliance with ethical standards

Competing interests

The authors declare that they have no competing interests.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Section of Gastroenterology, Department of MedicineTemple University School of MedicinePhiladelphiaUSA
  2. 2.Department of MedicineReading Hospital –Tower HealthReadingUSA

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