Validation of a score chart to predict the risk of chronic mesenteric ischemia and development of an updated score chart

Autor: Dijk, L.J.D. van, Noord, D. van, Geelkerken, R.H., Harki, J., Berendsen, S.A., Vries, A.C. de, Moelker, A., Vergouwe, Y., Verhagen, H.J.M., Kolkman, J.J., Bruno, M.J., Balm, R., Borst, G.J. de, Blauw, J.T., Bakker, O.J., Buscher, H.C.J.L., Fioole, B., Hamming, J.F., Heuvel, D.A.F. van den, Hattum, E.S. van, Hinnen, J.W., Laan, M.J. van der, Lenaerts, K., Peppelenbosch, M.P., Petersen, A.S. van, Rijnja, P., Schaar, P.J. van der, Terlouw, L.G., Vries, J.P.P.M. de, Vroegindeweij, D., Dutch Mesenteric Ischemia Study Gr
Přispěvatelé: Gastroenterology & Hepatology, Radiology & Nuclear Medicine, Public Health, Surgery, ​Robotics and image-guided minimally-invasive surgery (ROBOTICS), RS: NUTRIM - R2 - Liver and digestive health, Multi-Modality Medical Imaging
Rok vydání: 2019
Předmět:
Male
Vasodilator Agents
Constriction
Pathologic
DUPLEX ULTRASOUND
Cohort Studies
0302 clinical medicine
Symptom relief
Celiac artery
celiac artery
Prospective Studies
Prospective cohort study
median arcuate ligament syndrome
chronic mesenteric ischemia
Aged
80 and over
GASTRIC EXERCISE TONOMETRY
Gastroenterology
Angiography
superior mesenteric artery
Middle Aged
Mesenteric Arteries
prediction model
Oncology
Cardiovascular Diseases
030220 oncology & carcinogenesis
Female
030211 gastroenterology & hepatology
Median arcuate ligament syndrome
VISIBLE-LIGHT SPECTROSCOPY
CT
Adult
medicine.medical_specialty
computed tomography magnetic resonance angiography
chemical and pharmacologic phenomena
DIAGNOSIS
Risk Assessment
complex mixtures
CHRONIC GASTROINTESTINAL ISCHEMIA
03 medical and health sciences
Sex Factors
Chart
Mesenteric Artery
Superior
Internal medicine
medicine.artery
Weight Loss
medicine
MANAGEMENT
Humans
Aged
business.industry
Original Articles
medicine.disease
Stenosis
Chronic mesenteric ischemia
Mesenteric Ischemia
Chronic Disease
atherosclerosis
Intermediate risk
business
Zdroj: United European Gastroenterology Journal, 7(9), 1261-1270. SAGE Publishing
United European Gastroenterology Journal, 7(9), 1261-1270. SAGE PUBLICATIONS INC
United European Gastroenterology Journal, 7(9), 1261-1270. SAGE Publications Inc.
United European gastroenterology journal, 7(9), 1261-1270. Sage
United European Gastroenterology Journal
ISSN: 2050-6406
Popis: Background and objective: The objective of this article is to externally validate and update a recently published score chart for chronic mesenteric ischemia (CMI). Methods: A multicenter prospective cohort analysis was conducted of 666 CMI-suspected patients referred to two Dutch specialized CMI centers. Multidisciplinary consultation resulted in expert-based consensus diagnosis after which CMI consensus patients were treated. A definitive diagnosis of CMI was established if successful treatment resulted in durable symptom relief. The absolute CMI risk was calculated and discriminative ability of the original chart was assessed by the c-statistic in the validation cohort. Thereafter the original score chart was updated based on the performance in the combined original and validation cohort with inclusion of celiac artery (CA) stenosis cause. Results: In 8% of low-risk patients, 39% of intermediate-risk patients and 94% of high-risk patients of the validation cohort, CMI was diagnosed. Discriminative ability of the original model was acceptable (c-statistic 0.79). The total score of the updated chart ranged from 0 to 28 points (low risk 19% absolute CMI risk, intermediate risk 45%, and high risk 92%). The discriminative ability of the updated chart was slightly better (c-statistic 0.80). Conclusion: The CMI prediction model performs and discriminates well in the validation cohort. The updated score chart has excellent discriminative ability and is useful in clinical decision making.
Databáze: OpenAIRE
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