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Diagnostic accuracy of plasma biomarkers for intestinal ischaemia

Block, T ; Nilsson, TK ; Bjorck, M and Acosta, Stefan LU (2008) In Scandinavian Journal of Clinical & Laboratory Investigation 68(3). p.242-248
Abstract
Objective . Intestinal ischaemia is a life-threatening condition with high mortality, and the lack of accurate and readily available diagnostic methods often results in delay in diagnosis and treatment. The aim of this study was to investigate the accuracy of different plasma biomarkers in diagnosing intestinal ischaemia. Material and methods . Prospective inclusion of patients older than 50 years with acute abdomen admitted to hospital in Karlskrona, Sweden, between 2001 and 2003. Venous blood was sampled prior to any surgery and within 24 h from onset of pain. D-lactate, alpha glutathione S-transferase, intestinal fatty acid binding protein, creatine kinase B, isoenzymes of lactate dehydrogenase (LD) and alkaline liver phosphatase (ALP)... (More)
Objective . Intestinal ischaemia is a life-threatening condition with high mortality, and the lack of accurate and readily available diagnostic methods often results in delay in diagnosis and treatment. The aim of this study was to investigate the accuracy of different plasma biomarkers in diagnosing intestinal ischaemia. Material and methods . Prospective inclusion of patients older than 50 years with acute abdomen admitted to hospital in Karlskrona, Sweden, between 2001 and 2003. Venous blood was sampled prior to any surgery and within 24 h from onset of pain. D-lactate, alpha glutathione S-transferase, intestinal fatty acid binding protein, creatine kinase B, isoenzymes of lactate dehydrogenase (LD) and alkaline liver phosphatase (ALP) were analysed. D-dimer was analysed using four different commercially available test kits. Results . In-hospital mortalities among patients with (n = 10) and without (n = 61) intestinal ischaemia were 40 % and 3 %, respectively (p = 0.003). D-dimer was associated with intestinal ischaemia (p = 0.001) independently of which assay was used. No patient presenting with a normal D-dimer had intestinal ischaemia. D-dimer >0.9 mg/L had a specificity, sensitivity and accuracy of 82 %, 60 % and 79 %, respectively. Total LD, isoenzymes of LD 1-4 and liver isoenzyme of ALP (ALP liver) were significantly higher in patients with intestinal ischaemia, and accuracies for LD 2 (cut-off 2.3 microkat/L) and ALP liver (cut-off 0.7 microkat/L) were 69 % and 66 %, respectively. Conclusions. D-dimer may be used as an exclusion test for intestinal ischaemia, but lacks specificity. The other plasma biomarkers studied had insufficient accuracy for this group of patients. Further studies are needed. (Less)
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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Scandinavian Journal of Clinical & Laboratory Investigation
volume
68
issue
3
pages
242 - 248
publisher
Informa Healthcare
external identifiers
  • pmid:17934974
  • wos:000255454500009
  • scopus:49849093697
  • pmid:17934974
ISSN
1502-7686
DOI
10.1080/00365510701646264
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Emergency medicine/Medicine/Surgery (013240200)
id
2910d34e-79d3-4a7a-880b-f6f182695042 (old id 1139253)
date added to LUP
2016-04-01 14:28:20
date last changed
2020-12-01 03:50:54
@article{2910d34e-79d3-4a7a-880b-f6f182695042,
  abstract     = {Objective . Intestinal ischaemia is a life-threatening condition with high mortality, and the lack of accurate and readily available diagnostic methods often results in delay in diagnosis and treatment. The aim of this study was to investigate the accuracy of different plasma biomarkers in diagnosing intestinal ischaemia. Material and methods . Prospective inclusion of patients older than 50 years with acute abdomen admitted to hospital in Karlskrona, Sweden, between 2001 and 2003. Venous blood was sampled prior to any surgery and within 24 h from onset of pain. D-lactate, alpha glutathione S-transferase, intestinal fatty acid binding protein, creatine kinase B, isoenzymes of lactate dehydrogenase (LD) and alkaline liver phosphatase (ALP) were analysed. D-dimer was analysed using four different commercially available test kits. Results . In-hospital mortalities among patients with (n = 10) and without (n = 61) intestinal ischaemia were 40 % and 3 %, respectively (p = 0.003). D-dimer was associated with intestinal ischaemia (p = 0.001) independently of which assay was used. No patient presenting with a normal D-dimer had intestinal ischaemia. D-dimer >0.9 mg/L had a specificity, sensitivity and accuracy of 82 %, 60 % and 79 %, respectively. Total LD, isoenzymes of LD 1-4 and liver isoenzyme of ALP (ALP liver) were significantly higher in patients with intestinal ischaemia, and accuracies for LD 2 (cut-off 2.3 microkat/L) and ALP liver (cut-off 0.7 microkat/L) were 69 % and 66 %, respectively. Conclusions. D-dimer may be used as an exclusion test for intestinal ischaemia, but lacks specificity. The other plasma biomarkers studied had insufficient accuracy for this group of patients. Further studies are needed.},
  author       = {Block, T and Nilsson, TK and Bjorck, M and Acosta, Stefan},
  issn         = {1502-7686},
  language     = {eng},
  number       = {3},
  pages        = {242--248},
  publisher    = {Informa Healthcare},
  series       = {Scandinavian Journal of Clinical & Laboratory Investigation},
  title        = {Diagnostic accuracy of plasma biomarkers for intestinal ischaemia},
  url          = {http://dx.doi.org/10.1080/00365510701646264},
  doi          = {10.1080/00365510701646264},
  volume       = {68},
  year         = {2008},
}