Alexandre Nuzzo1,2, Francisca Joly1,2, Maxime Ronot2,3, Yves Castier4, Audrey Huguet1,2, Catherine Paugam-Burtz2,5, Dominique Cazals-Hatem2,6, Alexy Tran-Dinh2,7, Aymeric Becq1,2, Yves Panis2,8, Yoram Bouhnik1,2, Leon Maggiori2,8, Olivier Corcos1,2. 1. APHP, Deparment of Gastroenterology, IBD and Intestinal Failure, Beaujon Hospital, Clichy, France. 2. University of Paris, Paris, France. 3. APHP, Department of Radiology, Beaujon Hospital, Clichy, France. 4. APHP, Department of Vascular Surgery, Bichat Hospital, Paris, France. 5. APHP, Department of Anesthesia and Intensive Care, Beaujon Hospital, Clichy, France. 6. APHP, Department of Pathology, Beaujon Hospital, Clichy, France. 7. APHP, Department of Anesthesia and Intensive Care, Bichat Hospital, Paris, France. 8. APHP, Department of Colorectal Surgery, Beaujon Hospital, Clichy, France.
Abstract
INTRODUCTION: To investigate the factors associated with a delayed diagnosis (DD) of acute mesenteric ischemia (AMI). METHODS: An observational cohort study from an intestinal failure center. The primary outcome was DD >24 hours. RESULTS: 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. DISCUSSION: Suspicion of AMI should no longer be affected by normal plasma lactate levels and should prompt evaluation by a contrast-enhanced computed tomography-scan.
INTRODUCTION: To investigate the factors associated with a delayed diagnosis (DD) of acute mesenteric ischemia (AMI). METHODS: An observational cohort study from an intestinal failure center. The primary outcome was DD >24 hours. RESULTS: 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. DISCUSSION: Suspicion of AMI should no longer be affected by normal plasma lactate levels and should prompt evaluation by a contrast-enhanced computed tomography-scan.
Authors: Lillian M Tran; Elizabeth Andraska; Lindsey Haga; Natalie Sridharan; Rabih A Chaer; Mohammad H Eslami Journal: J Vasc Surg Date: 2021-10-08 Impact factor: 4.268