Autor: |
Kadri Tamme, Stefan Acosta, Alan Biloslavo, Martin Björck, Dumitru Casian, Dimitrios Damaskos, Alastair Forbes, Karri Kase, Kalle Kisand, Ines Lakbar, Vladislav Mihnovitš, Marko Murruste, Merli Mändul, Alexandre Nuzzo, Martin Padar, Joel Starkopf, Diego Visconti, Annika Reintam Blaser |
Jazyk: |
angličtina |
Rok vydání: |
2024 |
Předmět: |
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Zdroj: |
BMC Surgery, Vol 24, Iss 1, Pp 1-9 (2024) |
Druh dokumentu: |
article |
ISSN: |
1471-2482 |
DOI: |
10.1186/s12893-024-02491-3 |
Popis: |
Abstract Background Acute mesenteric ischaemia (AMI) is a life-threatening disease where early diagnosis is critical to avoid morbidity and mortality from extensive irreversible bowel necrosis. Appropriate prediction of presence of bowel necrosis is currently not available but would help to choose the optimal method of treatment. The study aims to identify combinations of biomarkers that can reliably identify AMI and distinguish between potentially reversible and irreversible bowel ischaemia. Methods This is a prospective multicentre study. Adult patients with clinical suspicion of AMI (n = 250) will be included. Blood will be sampled on admission, at and after interventions, or during the first 48 h of suspicion of AMI if no intervention undertaken. Samples will be collected and the following serum or plasma biomarkers measured at Tartu University Hospital laboratory: intestinal fatty acid-binding protein (I-FABP), alpha-glutathione S-transferase (Alpha- GST), interleukin 6 (IL-6), procalcitonin (PCT), ischaemia-modified albumin (IMA), D-lactate, D-dimer, signal peptide-CUB-EGF domain-containing protein 1 (SCUBE-1) and lipopolysaccharide-binding protein (LBP). Additionally, more common laboratory markers will be measured in routine clinical practice at study sites. Diagnosis of AMI will be confirmed by computed tomography angiography, surgery, endoscopy or autopsy. Student’s t or Wilcoxon rank tests will be used for comparisons between transmural vs. suspected (but not confirmed) AMI (comparison A), confirmed AMI of any stage vs suspected AMI (comparison B) and non-transmural AMI vs transmural AMI (comparison C). Optimal cut-off values for each comparison will be identified based on the AUROC analysis and likelihood ratios calculated. Positive likelihood ratio > 10 (> 5) and negative likelihood ratio |
Databáze: |
Directory of Open Access Journals |
Externí odkaz: |
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