Accuracy of using serum D-dimer for diagnosis of acute intestinal ischemia

Sun, Dingyong; Li, Shumin; Cen, Yunyun; Xu, Qianqian; Li, Yijun; Sun, Yucheng; Qi, Yanfei; Lin, Yueying; Yang, Ting; An, Li-Ya; Su, Kun; Li, Weiming; Xu, Pan

doi:10.1097/md.0000000000006380

Cited by 24 publications

(19 citation statements)

References 33 publications

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“…In 2017, a meta-analysis performed by Sun et al included more studies (12 studies; 1300 patients), eight of which concerned AMI. The four other studies dealt with acute strangulated intestinal obstruction, acute intestinal necrosis and mixed types of acute intestinal ischemia, which could be gathered into the term "acute intestinal ischemia"; the calculated sensitivity and specificity were 94% and 50%, respectively [149]. D-dimer measurement could hence be useful for identifying patients with AMI.…”

Section: Acute Mesenteric Ischemiamentioning

confidence: 99%

D-dimer: Preanalytical, analytical, postanalytical variables, and clinical applications

Favresse

Lippi

Roy

et al. 2018

Critical Reviews in Clinical Laboratory Sciences

160

103

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D-dimer is a soluble fibrin degradation product deriving from the plasmin-mediated degradation of cross-linked fibrin. D-dimer can hence be considered a biomarker of activation of coagulation and fibrinolysis, and it is routinely used for ruling out venous thromboembolism (VTE). D-dimer is increasingly used to assess the risk of VTE recurrence and to help define the optimal duration of anticoagulation treatment in patients with VTE, for diagnosing disseminated intravascular coagulation, and for screening medical patients at increased risk of VTE. This review is aimed at (1) revising the definition of D-dimer; (2) discussing preanalytical variables affecting the measurement of D-dimer; (3) reviewing and comparing assay performance and some postanalytical variables (e.g. different units and age-adjusted cutoffs); and (4) discussing the use of D-dimer measurement across different clinical settings.

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Section: Acute Mesenteric Ischemiamentioning

confidence: 99%

D-dimer: Preanalytical, analytical, postanalytical variables, and clinical applications

Favresse

Lippi

Roy

et al. 2018

Critical Reviews in Clinical Laboratory Sciences

160

103

View full text Add to dashboard Cite

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“…The inclusion of both occlusive and non-occlusive forms of i3, as discussed in the larger paper of Matsumoto et al [33], could lead, however, to high heterogeneity in patients. However, a recent meta-analysis estimated the area under the curve (AUC) of the receiver operating curve (ROC) of D-dimer to 0.81, underlying its potential utility in clinical practice [35].…”

Section: Biological Markers Of Thrombosismentioning

confidence: 99%

Diagnosis biomarkers in acute intestinal ischemic injury: so close, yet so far

Peoc’h

Nuzzo

Guedj

et al. 2017

Clinical Chemistry and Laboratory Medicine (CCLM)

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Acute intestinal ischemic injury (i3) is a lifethreatening condition with disastrous prognosis, which is currently difficult to diagnose at the early stages of the disease; a rapid diagnosis is mandatory to avoid irreversible ischemia, extensive bowel resection, sepsis and death. The overlapping protein expression of liver and gut related to the complex physiopathology of the disease, the heterogeneity of the disease and its relative rarity could explain the lack of a useful early biochemical marker of i3. Apart from non-specific biological markers of thrombosis, hypoxia inflammation, and infection, several more specific biomarkers in relation with the gut barrier dysfunction, the villi injury and the enterocyte mass have been used in the diagnosis of acute i3. It includes particularly D-lactate, intestinal fatty acid-binding protein (FABP) and citrulline. Herein, we will discuss leading publications concerning these historical markers that point out the main limitations reagrding their use in routine clinical practice. We will also introduce the first and limited results arising from omic studies, underlying the remaining effort that needs to be done in the field of acute i3 biological diagnosis, which remains a challenge.

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“…In 2009, a prospective, non-interventional study showed the median D-dimer level in acute mesenteric ischemia was 6240 ng fibrinogen equivalent units (FEU)/mL, with a range from 960 to 5348 ng FEU/mL. In 2017, Da-Li Sun et al reported that the combined sensitivity was 94%, the specificity was 50%, the positive likelihood ratio was 1.9, the negative likelihood ratio was 0.12, the diagnostic odds ratio was 16 and the area under the curve (AUC) was 0.81 for a total of 1300 patients studied [4]. In our case, the elevated D-dimer of up to 3548.18 ng/mL may have been a hint for the physicians to attempt to identify the cause, such as pulmonary embolism, aorta dissection, and acute mesenteric infarction.…”

Section: Discussionmentioning

confidence: 99%

Ischemic Bowel Disease Due to Superior Mesenteric Artery Occlusion: A Case Report

Lee

Chen

et al. 2018

Reports

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Acute mesenteric infarction is a rare but emergency disease with a high mortality rate. The rapidly restoration of intestinal blood flow is the early goal of vascular intervention. However, the unspecific presentation may confuse physicians and delay a timely diagnosis. The rate of intestinal failure in survivors is still high. Here, we present the case of an 85-year-old male presenting with acute onset progressive periumbilical cramping pain with elevated D-dimer. The abdominal computed tomography (CT) revealed severe acute superior mesenteric artery occlusion. The surgical report showed a massively ischemic small intestine that was about 250 cm with 200 mL bloody ascites. We highlight that early diagnosis and timely intervention are important for improving outcomes.

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Accuracy of using serum D-dimer for diagnosis of acute intestinal ischemia

Abstract: Supplemental Digital Content is available in the text

Cited by 24 publications

References 33 publications

D-dimer: Preanalytical, analytical, postanalytical variables, and clinical applications

D-dimer: Preanalytical, analytical, postanalytical variables, and clinical applications

Diagnosis biomarkers in acute intestinal ischemic injury: so close, yet so far

Ischemic Bowel Disease Due to Superior Mesenteric Artery Occlusion: A Case Report

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