Normal Lactate and Unenhanced CT-Scan Result in Delayed Diagnosis of Acute Mesenteric Ischemia.

Nuzzo, Alexandre; Joly, Francisca; Ronot, Maxime; Castier, Yves; Huguet, Audrey; Paugam-Burtz, Catherine; Cazals-Hatem, Dominique; Tran-Dinh, Alexy et al. · Am J Gastroenterol · 2020

retrospective_cohort · Level III

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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.

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