Soltanzadeh-Naderi Yasmin, Reintam Blaser Annika, Björck Martin, Nuzzo Alexandre, Starkopf Joel, Forbes Alastair, Murruste Marko, Tamme Kadri, Talving Peep, Voomets Anna-Liisa, Koitmäe Merli, Bala Miklosh, Bodnar Zsolt, Casian Dumitru, Demetrashvili Zaza, D'Oria Mario, Dúran Muñoz-Cruzado Virginia, Fuglseth Hanne, Itzhaki Moran Hellerman, Hess Benjamin, Kase Karri, Lein Kristoffer, Lindner Matthias, Loudet Cecilia I, Mole Damian J, Saar Sten, Scheiterle Maximilian, Voon Kenneth, Tverring Jonas, Acosta Stefan
Department of Clinical Sciences, Malmö, Lund University, 214 28 Malmö, Sweden.
Institute of Clinical Medicine, University of Tartu, 50090 Tartu, Estonia.
Diagnostics (Basel). 2024 Nov 30;14(23):2705. doi: 10.3390/diagnostics14232705.
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.
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.
The number of patients with arterial occlusive AMI was 231, consisting of thrombotic ( = 104), embolic ( = 61), and indeterminate ( = 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.
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.
目前尚无能够准确诊断急性肠系膜缺血（AMI）的临床或实验室标志物。本研究旨在找出动脉闭塞性AMI与最初疑似AMI的其他急性腹部疾病在临床和实验室标志物方面的差异。
这是一项对一项国际前瞻性多中心研究的事后分析，该研究收集了疑似AMI患者的数据。在多变量逻辑回归分析中评估与动脉闭塞性AMI相关的独立因素。
动脉闭塞性AMI患者有231例，包括血栓形成性（=104）、栓塞性（=61）和不明原因（=66）闭塞。非AMI组包括287例患者，其中128例为绞窄性肠梗阻。与非AMI组相比，入院时当前吸烟（优势比[OR]2.56，95%置信区间[CI]1.31 - 5.03）、高血压（OR 2.08，95%CI 1.09 - 3.97）、肠道排空（OR 3.25，95%CI 1.59 - 6.63）和白细胞增多（OR 1.54，95%CI 1.14 - 2.08）与动脉闭塞性AMI独立相关。
本研究发现临床和实验室数据与疑似AMI患者的动脉闭塞性AMI相关，这可能对急诊科筛查动脉闭塞性AMI有价值。需要进一步研究以找到更准确的诊断标志物。
