Diagnostic Performance of Clinical and Routine Laboratory Data in Acute Mesenteric Arterial Occlusion—An International Multicenter Study
Yasmin Soltanzadeh-Naderi,
Annika Reintam Blaser,
Martin Björck,
Alexandre Nuzzo,
Joel Starkopf,
Alastair Forbes,
Marko Murruste,
Kadri Tamme,
Peep Talving,
Anna-Liisa Voomets,
Merli Koitmäe,
Miklosh Bala,
Zsolt Bodnar,
Dumitru Casian,
Zaza Demetrashvili,
Mario D’Oria,
Virginia Dúran Muñoz-Cruzado,
Hanne Fuglseth,
Moran Hellerman Itzhaki,
Benjamin Hess,
Karri Kase,
Kristoffer Lein,
Matthias Lindner,
Cecilia I. Loudet,
Damian J. Mole,
Sten Saar,
Maximilian Scheiterle,
Kenneth Voon,
Jonas Tverring,
Stefan Acosta
Affiliations
Yasmin Soltanzadeh-Naderi
Department of Clinical Sciences, Malmö, Lund University, 214 28 Malmö, Sweden
Annika Reintam Blaser
Institute of Clinical Medicine, University of Tartu, 50090 Tartu, Estonia
Martin Björck
Institute of Clinical Medicine, University of Tartu, 50090 Tartu, Estonia
Alexandre Nuzzo
Department of Gastroenterology, IBD and Intestinal Failure, Intestinal Stroke Center, AP-HP. Nord, Beaujon Hospital, Paris Cité University, 75006 Paris, France
Joel Starkopf
Institute of Clinical Medicine, University of Tartu, 50090 Tartu, Estonia
Alastair Forbes
Institute of Clinical Medicine, University of Tartu, 50090 Tartu, Estonia
Marko Murruste
Institute of Clinical Medicine, University of Tartu, 50090 Tartu, Estonia
Kadri Tamme
Institute of Clinical Medicine, University of Tartu, 50090 Tartu, Estonia
Peep Talving
Institute of Clinical Medicine, University of Tartu, 50090 Tartu, Estonia
Anna-Liisa Voomets
Tartu University Hospital, 50406 Tartu, Estonia
Merli Koitmäe
Estonian Genome Center, Institute of Genomics, University of Tartu, 50090 Tartu, Estonia
Miklosh Bala
Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190500, Israel
Zsolt Bodnar
Letterkenny University Hospital, Letterkenny F92 AE81, Ireland
Dumitru Casian
Department of General Surgery, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova, MD-2004 Chisinau, Moldova
Zaza Demetrashvili
N. Kipshidze Central University Hospital, 6160 Tbilisi, Georgia
Mario D’Oria
Division of Vascular and Endovascular Surgery, Department of Clinical Surgical and Health Sciences, University of Trieste, 34127 Trieste, Italy
Virginia Dúran Muñoz-Cruzado
Virgen del Rocío University Hospital, 41013 Sevilla, Spain
Hanne Fuglseth
Stavanger University Hospital, 4011 Stavanger, Norway
Moran Hellerman Itzhaki
Rabin Medical Center, University of Tel Aviv, Petah Tikva 4941492, Israel
Benjamin Hess
Department of Intensive Care Medicine, Lucerne Cantonal Hospital, 6000 Lucerne, Switzerland
Karri Kase
Institute of Clinical Medicine, University of Tartu, 50090 Tartu, Estonia
Kristoffer Lein
University Hospital North Norway, 9019 Tromsø, Norway
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.
