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

Yasmin Soltanzadeh-Naderi¹, Annika Reintam Blaser^{2

3}, Martin Björck^{2

4}, Alexandre Nuzzo⁵, Joel Starkopf^{2

6}, Alastair Forbes², Marko Murruste^{2

6}, Kadri Tamme^{2

6}, Peep Talving^{2

7}, Anna-Liisa Voomets⁶, Merli Koitmäe^{8

9}, Miklosh Bala¹⁰, Zsolt Bodnar¹¹, Dumitru Casian¹², Zaza Demetrashvili¹³, Mario D'Oria¹⁴, Virginia Dúran Muñoz-Cruzado¹⁵, Hanne Fuglseth¹⁶, Moran Hellerman Itzhaki¹⁷, Benjamin Hess³, Karri Kase^{2

6}, Kristoffer Lein¹⁸, Matthias Lindner¹⁹, Cecilia I Loudet²⁰, Damian J Mole²¹, Sten Saar²², Maximilian Scheiterle²³, Kenneth Voon²⁴, Jonas Tverring²⁵, Stefan Acosta¹; 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 Intensive Care Medicine, Lucerne Cantonal Hospital, 6000 Lucerne, Switzerland.
⁴ Department of Surgical Sciences, Vascular Surgery, Uppsala University, 753 10 Uppsala, Sweden.
⁵ Department of Gastroenterology, IBD and Intestinal Failure, Intestinal Stroke Center, AP-HP. Nord, Beaujon Hospital, Paris Cité University, 75006 Paris, France.
⁶ Tartu University Hospital, 50406 Tartu, Estonia.
⁷ Division of Acute Care Surgery, North Estonia Medical Centre, 13419 Tallinn, Estonia.
⁸ Estonian Genome Center, Institute of Genomics, University of Tartu, 50090 Tartu, Estonia.
⁹ Institute of Mathematics and Statistics, University of Tartu, 50090 Tartu, Estonia.
¹⁰ Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190500, Israel.
¹¹ Letterkenny University Hospital, Letterkenny F92 AE81, Ireland.
¹² Department of General Surgery, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova, MD-2004 Chisinau, Moldova.
¹³ N. Kipshidze Central University Hospital, 6160 Tbilisi, Georgia.
¹⁴ Division of Vascular and Endovascular Surgery, Department of Clinical Surgical and Health Sciences, University of Trieste, 34127 Trieste, Italy.
¹⁵ Virgen del Rocío University Hospital, 41013 Sevilla, Spain.
¹⁶ Stavanger University Hospital, 4011 Stavanger, Norway.
¹⁷ Rabin Medical Center, University of Tel Aviv, Petah Tikva 4941492, Israel.
¹⁸ University Hospital North Norway, 9019 Tromsø, Norway.
¹⁹ Universitätsklinikum Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany.
²⁰ Hospital General San Martin de La Plata, Buenos Aires B1900, Argentina.
²¹ Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK.
²² North Estonia Medical Centre, 13419 Tallinn, Estonia.
²³ Azienda Ospedaliera Universitaria Careggi, 50134 Firenze, Italy.
²⁴ Sarawak General Hospital, Kuching 93586, Malaysia.
²⁵ Department of Clinical Sciences, Lund, Lund University, 221 00 Lund, Sweden.

PMID: 39682613
PMCID: PMC11640103
DOI: 10.3390/diagnostics14232705

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

Yasmin Soltanzadeh-Naderi et al. Diagnostics (Basel). 2024.

. 2024 Nov 30;14(23):2705.

doi: 10.3390/diagnostics14232705.

Authors

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 Intensive Care Medicine, Lucerne Cantonal Hospital, 6000 Lucerne, Switzerland.
⁴ Department of Surgical Sciences, Vascular Surgery, Uppsala University, 753 10 Uppsala, Sweden.
⁵ Department of Gastroenterology, IBD and Intestinal Failure, Intestinal Stroke Center, AP-HP. Nord, Beaujon Hospital, Paris Cité University, 75006 Paris, France.
⁶ Tartu University Hospital, 50406 Tartu, Estonia.
⁷ Division of Acute Care Surgery, North Estonia Medical Centre, 13419 Tallinn, Estonia.
⁸ Estonian Genome Center, Institute of Genomics, University of Tartu, 50090 Tartu, Estonia.
⁹ Institute of Mathematics and Statistics, University of Tartu, 50090 Tartu, Estonia.
¹⁰ Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9190500, Israel.
¹¹ Letterkenny University Hospital, Letterkenny F92 AE81, Ireland.
¹² Department of General Surgery, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova, MD-2004 Chisinau, Moldova.
¹³ N. Kipshidze Central University Hospital, 6160 Tbilisi, Georgia.
¹⁴ Division of Vascular and Endovascular Surgery, Department of Clinical Surgical and Health Sciences, University of Trieste, 34127 Trieste, Italy.
¹⁵ Virgen del Rocío University Hospital, 41013 Sevilla, Spain.
¹⁶ Stavanger University Hospital, 4011 Stavanger, Norway.
¹⁷ Rabin Medical Center, University of Tel Aviv, Petah Tikva 4941492, Israel.
¹⁸ University Hospital North Norway, 9019 Tromsø, Norway.
¹⁹ Universitätsklinikum Schleswig-Holstein, Campus Kiel, 24105 Kiel, Germany.
²⁰ Hospital General San Martin de La Plata, Buenos Aires B1900, Argentina.
²¹ Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK.
²² North Estonia Medical Centre, 13419 Tallinn, Estonia.
²³ Azienda Ospedaliera Universitaria Careggi, 50134 Firenze, Italy.
²⁴ Sarawak General Hospital, Kuching 93586, Malaysia.
²⁵ Department of Clinical Sciences, Lund, Lund University, 221 00 Lund, Sweden.

PMID: 39682613
PMCID: PMC11640103
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.

Keywords: acute mesenteric ischemia; acute superior mesenteric artery; arterial occlusive AMI; clinical diagnosis; laboratory markers.

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Conflict of interest statement

A.R.B has received speaker or consultancy fees from Nestlé, VIPUN Medical, Nutricia, and Fresenius Kabi, and holds a grant from the Estonian Research Council (PRG1255). AF has received speaker fees from B Braun and Fresenius Kabi. A.N. has received speaker or consultancy fees from Abbvie and Janssen, research funding from MSD-Avenir, and PhD grants from Fondation de l’Avenir and SNFGE. Y.S.-N., M.B. (Martin Björck), J.S., M.M., K.T., O.T., A.-L.V., M.K., M.B. (Miklosh Bala), Z.B., D.C., Z.D., M.D., V.D.M.-C., H.F., M.H.I., B.H., K.K., K.L., M.L., C.I.L., D.J.M., S.S., M.S., K.V., J.T., and S.A reports no conflicts of interest.

Figures

**Figure A1**
Box plot graph showing median and interquartile range (IQR) values of plasma lactate at different time ranges before diagnosis of arterial occlusive acute mesenteric ischemia (AMI) and non-AMI, respectively. The line across the box indicates the median, the box represents the interquartile range, and the whiskers are lines that extend from the box edges to the highest and lowest values, excluding outliers. Values more than 1.5 IQR’s but less than 3 IQR’s (o), and more than 3 IQR’s (*), from the box edges are labeled as outliers and extremes, respectively.

See this image and copyright information in PMC

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

Affiliations

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

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Grants and funding

LinkOut - more resources

Full Text Sources