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Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
D-dimer in patients with suspected acute mesenteric ischemia
Yu-Hui Chiu1, Ming-Kun Huang, Chorng-Kuang How
1Emergency Department, Taipei Veterans General Hospital, Taipei, Taiwan.
The American Journal of Emergency Medicine
|October 28, 2009
Summary
Serum D-dimer testing has poor diagnostic value for acute mesenteric ischemia (AMI). While a low D-dimer level may slightly decrease the likelihood of AMI, it cannot reliably differentiate AMI from other conditions or predict disease severity.
Area of Science:
- Gastroenterology
- Vascular Surgery
- Emergency Medicine
- Diagnostic Imaging
Background:
- Acute mesenteric ischemia (AMI) is a critical condition requiring prompt diagnosis.
- D-dimer is a biomarker often assessed in patients with suspected vascular events.
- The diagnostic utility of D-dimer in AMI remains debated.
Purpose of the Study:
- To evaluate the diagnostic performance of D-dimer in patients with suspected AMI.
- To determine the correlation between D-dimer levels and the extent of bowel necrosis in AMI.
Main Methods:
- Prospective study of 67 patients with clinical suspicion of AMI.
- D-dimer levels measured using a latex turbidimetric method.
- Analysis of diagnostic accuracy and correlation with surgical findings.
Main Results:
- AMI diagnosed in 34.3% of patients; non-AMI in 65.7%.
- Median D-dimer levels were higher in AMI patients (6.24 µg FEU/mL) vs. non-AMI (3.45 µg FEU/mL), but not statistically significant (P=.064).
- D-dimer showed poor discrimination for AMI (AUC=0.64) and no correlation with bowel necrosis severity.
Conclusions:
- Serum D-dimer lacks sufficient diagnostic value to distinguish AMI from non-AMI.
- D-dimer levels do not correlate with the severity of bowel necrosis in AMI.
- A low D-dimer result may offer a marginal reduction in the probability of AMI.
