Normal Lactate and Unenhanced CT-Scan Result in Delayed Diagnosis of Acute Mesenteric Ischemia.
retrospective_cohort · Level III
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- Record sourced from PubMed, PMID 33156109.
- Also identified by DOI 10.14309/ajg.0000000000000836.
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Abstract
To investigate the factors associated with a delayed diagnosis (DD) of acute mesenteric ischemia (AMI). An observational cohort study from an intestinal failure center. The primary outcome was DD >24 hours. Between 2006 and 2015, 74 patients with AMI were included and 39 (53%) had a DD. Plasma lactate <2 mmol/L (odd ratio: 3.2; 95% confidence interval: 1.1-9.1; P = 0.03) and unenhanced computed tomography scan (odds ratio: 5.9; 95% confidence interval: 1.4-25.8; P = 0.01) were independently associated with DD. Suspicion of AMI should no longer be affected by normal plasma lactate levels and should prompt evaluation by a contrast-enhanced computed tomography-scan.
Medical subject headings
- Abdominal Pain/physiopathology
- Acute Disease
- Adult
- Anastomosis, Surgical
- Chronic Disease
- Cohort Studies
- Colon/surgery
- Contrast Media
- Delayed Diagnosis/statistics & numerical data
- Early Diagnosis
- Early Medical Intervention
- Female
- Humans
- Intestine, Small/surgery
- Jejunostomy
- Lactic Acid/blood
- Male
- Mesenteric Ischemia/blood
- Mesenteric Ischemia/diagnostic imaging
- Mesenteric Ischemia/physiopathology
- Mesenteric Ischemia/surgery
- Middle Aged
- Retrospective Studies
- Risk Factors
- Short Bowel Syndrome
- Tomography, X-Ray Computed/methods
- Vomiting/physiopathology