Succoring the challenging acute mesenteric ischemia: Feasibility of lactate dehydrogenase for evaluation of intestinal necrosis extension and mortality

Conde Monroy, Danny; Giron-Arango, Felipe; Rodriguez Moreno, Lina; Rey-Chaves, Carlos Eduardo; Donoso-Samper, Andrea; Nassar, Ricardo; Isaza-Restrepo, Andrés

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dc.creator	Conde Monroy, Danny
dc.creator	Giron-Arango, Felipe
dc.creator	Rodriguez Moreno, Lina
dc.creator	Rey-Chaves, Carlos Eduardo
dc.creator	Donoso-Samper, Andrea
dc.creator	Nassar, Ricardo
dc.creator	Isaza-Restrepo, Andrés
dc.date.accessioned	2022-12-19T20:38:40Z
dc.date.available	2022-12-19T20:38:40Z
dc.date.created	2022-12
dc.identifier.issn	2049-0801	spa
dc.identifier.uri	http://repositorio.mederi.com.co/handle/123456789/724
dc.description	Background Acute mesenteric ischemia is a lethal challenging pathology for surgeons in the emergency department due to its ambiguous clinical presentation and lack of early diagnostic markers. Serum lactate is considered a relevant biomarker in terms of bowel necrosis length and mortality prediction. Nevertheless, its association has been poorly studied. Hence, we evaluated the relation between serum lactate admission levels, bowel necrosis extension, and mortality in patients with acute mesenteric ischemia. Methods A Retrospective cross-sectional study with a prospective database was conducted, including patients over 18 years old with mesenteric ischemia that required surgical management between January 2012 and December 2018. We describe the association between serum lactate admission levels with bowel necrosis length and mortality in patients with acute mesenteric ischemia. Results 74 patients presented with acute mesenteric ischemia, 44 males and 30 females. Mean age was 73.5 ± 10.7 years old. Significant association between serum lactate admission levels and mortality was found (ROC cut-value of 3.8 mmol/l, 81.0% sensibility and 76% specificity, LR+3.41 (95%CI 1.57, 7.40), LR- 0.25 (95%CI 0.13–0.45))(P.001). Nonetheless no statistically significant association was found between serum lactate admission levels and bowel necrosis length (ρ = 0.195,95%CI -0.046, −0.436, P > .99). As post hoc analysis, a classification and regression tree on mortality was fitted. Conclusions Early diagnosis, prognosis and management of mesenteric ischemia is vital given its high morbidity and mortality. Serum lactate admission levels can be considered as a useful prognostic tool in terms of mortality in patients with acute mesenteric ischemia.	spa
dc.format.mimetype	application/pdf	spa
dc.relation.uri	https://doi.org/10.1016/j.amsu.2022.104922	spa
dc.rights	Atribución-NoComercial-SinDerivadas 2.5 Colombia	*
dc.rights.uri	http://creativecommons.org/licenses/by-nc-nd/2.5/co/	*
dc.title	Succoring the challenging acute mesenteric ischemia: Feasibility of lactate dehydrogenase for evaluation of intestinal necrosis extension and mortality	spa
dc.subject.keyword	Mesenteric ischemia	spa
dc.subject.keyword	Lactate	spa
dc.subject.keyword	Surgery	spa
dc.rights.accessRights	openAccess	spa
dc.type.hasVersion	acceptedVersion	spa

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