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Diagnostic Performance of Clinical and Routine Laboratory Data in Acute Mesenteric Arterial Occlusion-An International Multicenter Study

Soltanzadeh-Naderi Y 1 , Reintam Blaser A 2 , Björck M 2 , Nuzzo A 3 , Starkopf J 2 , Forbes A 2 Show all authors , Murruste M 2 , Tamme K 2 , Talving P 2 , Voomets AL 4 , Koitmäe M 5 , Bala M 6 , Bodnar Z 7 , Casian D 8 , Demetrashvili Z 9 , D'Oria M 10 , Dúran Muñoz-Cruzado V 11 , Fuglseth H 12 , Itzhaki MH 13 , Hess B 14 , Kase K 2 , Lein K 15 , Lindner M 16 , Loudet CI 17 , Mole DJ 18 , Saar S 19 , Scheiterle M 20 , Voon K 21 , Tverring J 22 , Acosta S 1 , AMESI Investigators Collaborators

Affiliations 

  • 1 Department of Clinical Sciences, Malmö, Lund University, 214 28 Malmö, Sweden
  • 2 Institute of Clinical Medicine, University of Tartu, 50090 Tartu, Estonia
  • 3 Department of Gastroenterology, IBD and Intestinal Failure, Intestinal Stroke Center, AP-HP. Nord, Beaujon Hospital, Paris Cité University, 75006 Paris, France
  • 4 Tartu University Hospital, 50406 Tartu, Estonia
  • 5 Estonian Genome Center, Institute of Genomics, University of Tartu, 50090 Tartu, Estonia
  • 6 Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190500, Israel
  • 7 Letterkenny University Hospital, Letterkenny F92 AE81, Ireland
  • 8 Department of General Surgery, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova, MD-2004 Chisinau, Moldova
  • 9 N. Kipshidze Central University Hospital, 6160 Tbilisi, Georgia
  • 10 Division of Vascular and Endovascular Surgery, Department of Clinical Surgical and Health Sciences, University of Trieste, 34127 Trieste, Italy
  • 11 Virgen del Rocío University Hospital, 41013 Sevilla, Spain
  • 12 Stavanger University Hospital, 4011 Stavanger, Norway
  • 13 Rabin Medical Center, University of Tel Aviv, Petah Tikva 4941492, Israel
  • 14 Department of Intensive Care Medicine, Lucerne Cantonal Hospital, 6000 Lucerne, Switzerland
  • 15 University Hospital North Norway, 9019 Tromsø, Norway
  • 16 Universitätsklinikum Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany
  • 17 Hospital General San Martin de La Plata, Buenos Aires B1900, Argentina
  • 18 Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
  • 19 North Estonia Medical Centre, 13419 Tallinn, Estonia
  • 20 Azienda Ospedaliera Universitaria Careggi, 50134 Firenze, Italy
  • 21 Sarawak General Hospital, Kuching 93586, Malaysia
  • 22 Department of Clinical Sciences, Lund, Lund University, 221 00 Lund, Sweden
Diagnostics (Basel), 2024 Nov 30;14(23).
PMID: 39682613 DOI: 10.3390/diagnostics14232705

Abstract

BACKGROUND: There are no clinical or laboratory markers that can diagnose acute mesenteric ischemia (AMI) accurately. This study aimed to find differences in clinical and laboratory markers between arterial occlusive AMI and other acute abdominal diseases where AMI was initially suspected.

METHODS: This was a post hoc study of an international prospective multicenter study where data on patients with suspected AMI were collected. Independent factors associated with arterial occlusive AMI were evaluated in a multivariable logistic regression analysis.

RESULTS: The number of patients with arterial occlusive AMI was 231, consisting of thrombotic (n = 104), embolic (n = 61), and indeterminate (n = 66) occlusions. The non-AMI group included 287 patients, of whom 128 had strangulated bowel obstruction. Current smoking (odds ratio [OR] 2.56, 95% confidence interval [CI] 1.31-5.03), hypertension (OR 2.08, 95% CI 1.09-3.97), bowel emptying (OR 3.25, 95% CI 1.59-6.63), and leukocytosis (OR 1.54, 95% CI 1.14-2.08) at admission were independently associated with arterial occlusive AMI compared to the non-AMI group.

CONCLUSIONS: This study found clinical and laboratory data to be associated with arterial occlusive AMI in patients with suspicion of AMI, which can possibly be of value in screening for arterial occlusive AMI at the emergency department. Further studies are needed to find more accurate diagnostic markers.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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