Stefan Acosta, Annika Reintam Blaser, Alexandre Nuzzo, Yasmin Soltanzadeh-Naderi, Joel Starkopf, Alastair Forbes, Marko Murruste, Kadri Tamme, Anna-Liisa Voomets, Merli Koitmäe, Miklosh Bala, Zsolt Bodnar, Dumitru Casian, Zaza Demetrashvili, Alan Biloslavo, Virginia Dúran Muñoz-Cruzado, Benjamin Hess, Karri Kase, Mikhail Kirov, Matthias Lindner, Cecilia I Loudet, Dimitrios Damaskos, Martin Björck
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引用次数: 0
Abstract
Background: Acute mesenteric venous thrombosis (MVT) is rarely suspected as primary diagnosis in emergency departments and still carries an in-hospital mortality rate of above 20%.
Objectives: The aim of this study was to find differences in clinical and laboratory markers between patients with acute MVT and a control group of suspected but confirmed as not having any type of acute mesenteric ischaemia (AMI).
Design: Data was retrieved from the AMESI (Acute MESenteric Ischaemia) study. This international, multicenter prospective case-control study from 32 sites collected data on patients with suspected AMI during a 10-month period.
Methods: Independent factors associated with acute MVT were evaluated in a multivariable logistic regression analysis and expressed as odds ratios (OR) with 95% confidence intervals (CI).
Results: D-dimer was not significantly higher in MVT (n = 73) compared to non-AMI (n = 287) patients (median 7.0 mg/L vs 4.5 mg/L, P = .092). After entering BMI, atherosclerotic disease, history of venous thromboembolism, CRP, and D-dimer as covariates in a multi-variable logistic regression analysis, absence of atherosclerotic disease (OR 0.096, 95% CI 0.011-0.84; P = .034) and elevated D-dimer (OR 2.59/one SD increment, 95% CI 1.07-6.28; P = .034) were associated with MVT. The discriminative ability of D-dimer for MVT as assessed by area under the curve in the receiver operating characteristics analysis was 0.63 (95% CI 0.49-0.78).
Conclusion: Elevated D-dimer was associated with MVT, but the discriminative ability of D-dimer was poor. There is an urgent need to find a more accurate plasma biomarker for this condition.
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