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

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Diagnostic Performance of Clinical and Routine Laboratory Data in Acute Mesenteric Arterial Occlusion—An International Multicenter Study
by Yasmin Soltanzadeh-Naderi 1ORCID,Annika Reintam Blaser 2,3ORCID,Martin Björck 2,4,Alexandre Nuzzo 5ORCID,Joel Starkopf 2,6,Alastair Forbes 2,Marko Murruste 2,6ORCID,Kadri Tamme 2,6ORCID,Peep Talving 2,7,Anna-Liisa Voomets 6,Merli Koitmäe 8,9ORCID,Miklosh Bala 10ORCID,Zsolt Bodnar 11,Dumitru Casian 12ORCID,Zaza Demetrashvili 13,Mario D’Oria 14ORCID,Virginia Dúran Muñoz-Cruzado 15ORCID,Hanne Fuglseth 16ORCID,Moran Hellerman Itzhaki 17,Benjamin Hess 3,Karri Kase 2,6ORCID,Kristoffer Lein 18ORCID,Matthias Lindner 19,Cecilia I. Loudet 20ORCID,Damian J. Mole 21,Sten Saar 22,Maximilian Scheiterle 23ORCID,Kenneth Voon 24ORCID,Jonas Tverring 25ORCID and Stefan Acosta 1,*,†ORCID on behalf of AMESI Investigators Collaboratorsremove Hide full author list
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

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*
Author to whom correspondence should be addressed.
†
Collaborators team is provided in the Acknowledgments.
Diagnostics 2024, 14(23), 2705; https://doi.org/10.3390/diagnostics14232705
Submission received: 1 October 2024 / Revised: 22 November 2024 / Accepted: 27 November 2024 / Published: 30 November 2024
(This article belongs to the Collection Editorial Board Members' Collection Series: Diagnostic Approaches to Gastrointestinal and Pancreatic Diseases)
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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.