Multidetector Angio-CT and the Use of D-Dimer for the Diagnosis of Acute Mesenteric Ischemia in Geriatric Patients

Abstract

BACKGROUND:There is no specific laboratory method for the diagnosis of acute mesenteric ischemia (AMI). In this study, we aimed to determine the efficacy of the D-dimer test in selected cases prior to multi-detector angio-CT, which is expensive and has side effects.

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

“…1). Among the 11 excluded studies, [25–35] 6 did not report the sensitivity and specificity of D-dimer [25–30] ; 2 were duplicate reports [31,32] ; 1 had no definition of diagnostic criteria for acute intestinal ischemia [33] ; 1 did not describe the method by which the D-dimer was detected [34] ; and 1 did not report the cut-off values of D-dimer [35] Only 12 studies were eventually included in this meta-analysis, [13–24] with the years of publication ranging from 2004 to 2016 and including 1300 patients with suspected acute intestinal ischemia. Only 1 of them was a retrospective study, [22] and the others were prospective studies.…”

“…Only 1 of them was a retrospective study, [22] and the others were prospective studies. [13–21,23,24] Five of the included studies were conducted in Asia, [14,16,21–23] and the remaining 7 included studies were conducted in European countries. [13,15,17–20,24] The types of acute intestinal ischemia in the 12 included studies were reported differently.…”

“…[13–21,23,24] Five of the included studies were conducted in Asia, [14,16,21–23] and the remaining 7 included studies were conducted in European countries. [13,15,17–20,24] The types of acute intestinal ischemia in the 12 included studies were reported differently. There were 8 studies of acute mesenteric ischemia, [13–15,20–24] 1 study of acute strangulated intestinal obstruction, [17] 1 study of acute intestinal necrosis, [16] and 2 studies of mixed type of acute intestinal ischemia.…”

“…[13,15,17–20,24] The types of acute intestinal ischemia in the 12 included studies were reported differently. There were 8 studies of acute mesenteric ischemia, [13–15,20–24] 1 study of acute strangulated intestinal obstruction, [17] 1 study of acute intestinal necrosis, [16] and 2 studies of mixed type of acute intestinal ischemia. [18,19] Diagnostic criteria for acute intestinal ischemia included pathological examinations, intraoperative findings, radiological examination, laboratory test results, and clinical evaluation (Table 1).…”

“…Most of the studies included here used an immunofiltration assay to detect D-dimer [13–15,17–19,21] : 3 studies used immunoturbidimetry [16,22,23] and 2 studies used Latex-based immune measuring method. [20,24] Supplementary Table S1, summarizes the results of quality evaluation.…”