Diagnostic Accuracy of the Combination of Clinical Symptoms and CT or MR Angiography in Patients With Chronic Gastrointestinal Ischemia
| العنوان: | Diagnostic Accuracy of the Combination of Clinical Symptoms and CT or MR Angiography in Patients With Chronic Gastrointestinal Ischemia |
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| المؤلفون: | Eric T.T.L. Tjwa, Ernst J. Kuipers, Johannes A. Spoor, Peter Mensink, Jihan Harki, Marco J. Bruno, Désirée van Noord, Yvonne Vergouwe |
| المساهمون: | Gastroenterology & Hepatology, Public Health |
| المصدر: | Journal of Clinical Gastroenterology, 51(6), E39-E47. Lippincott Williams & Wilkins Journal of Clinical Gastroenterology, 51, 6, pp. e39-e47 Journal of Clinical Gastroenterology, 51, e39-e47 |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Computed Tomography Angiography, Gastrointestinal Diseases, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Celiac artery, Celiac Artery, Ischemia, Mesenteric Artery, Superior, Predictive Value of Tests, medicine.artery, mental disorders, medicine, Humans, Superior mesenteric artery, Prospective Studies, Prospective cohort study, Aged, medicine.diagnostic_test, business.industry, Gastroenterology, Odds ratio, Middle Aged, medicine.disease, Confidence interval, humanities, Stenosis, Logistic Models, Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11], Predictive value of tests, Angiography, Chronic Disease, Multivariate Analysis, 030211 gastroenterology & hepatology, Female, Radiology, business, Magnetic Resonance Angiography |
| الوصف: | Item does not contain fulltext BACKGROUND: No golden diagnostic standard is available to diagnose chronic gastrointestinal ischemia (CGI). GOALS: We aimed to establish an accurate prediction model for CGI, based on clinical symptoms and radiologic evaluation of the amount of stenosis in the celiac artery (CA) and superior mesenteric artery (SMA) by means of computed tomography-angiography or magnetic resonance (MR)-angiography. STUDY: We prospectively included 436 consecutive patients with clinical suspicion of CGI in a tertiary referral center. Predictors for CGI were obtained by comparing clinical parameters to the diagnosis of CGI. Multivariable logistic regression was used to combine the strongest predictors in a model. A score chart based on the prediction model was provided to calculate the risk of CGI. RESULTS: CGI was present in 171/436 (39%) patients (67 y; range, 54 to 74 y; 27% male). Strongest predictors for CGI were female gender [odds ratio (OR)=1.44; 95% confidence interval (CI), 0.85-2.43], weight loss (OR=1.63, 95% CI, 0.98-2.72), concomitant cardiovascular disease (OR=1.70, 95% CI, 1.04-2.78), duration of symptoms (OR=0.88, 95% CI, 0.79-0.99), and stenosis of CA and SMA (50% to 70% stenosis CA: OR=1.33, 95% CI, 0.56-3.19; >70% stenosis CA: OR=5.79, 95% CI, 3.42-9.81; 50% to 70% stenosis SMA: OR=3.21, 95% CI, 0.81-12.74; >70% stenosis SMA: OR=4.39, 95% CI, 2.30-8.41). A model based on clinical symptoms alone showed limited discriminative ability for diagnosing CGI (c-statistic 0.62). Adding radiologic imaging of the mesenteric arteries improved the discriminative ability (c-statistic 0.79). CONCLUSIONS: Clinical symptoms alone are insufficient to predict the risk of CGI. Radiologic evaluation of the mesenteric arteries is essential. This tool may be useful for clinicians to assess the risk of CGI and to decide whether further diagnostic work-up for CGI is needed. |
| تدمد: | 0192-0790 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::76848784ca6d4697c95a3ad7664f4cd1 https://doi.org/10.1097/MCG.0000000000000605 |
| حقوق: | RESTRICTED |
| رقم الأكسشن: | edsair.doi.dedup.....76848784ca6d4697c95a3ad7664f4cd1 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 01920790 |
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