The Diagnostic Value of Biomarkers in Acute Mesenteric Ischaemia Is Insufficiently Substantiated: A Systematic Review.

There is a high urgency of accurate biomarkers to support timely diagnosis of acute mesenteric ischaemia (AMI) and thereby improve clinical outcome. With this systematic review, the aim is to substantiate the potential diagnostic value of biomarkers for arterial occlusive AMI.The Pubmed, Embase, and the Cochrane Library electronic databases were searched.A systematic review of the literature has been conducted to define the potential diagnostic value of biomarkers for arterial occlusive AMI. All studies including ≥ 10 patients describing biomarkers for macrovascular occlusive AMI between 1950 and 17 February 2023 were identified within the Pubmed, Embase, and the Cochrane Library electronic databases. There were no restrictions to any particular study design, but letters and editorials were excluded. The QUADAS-2 tool was used for the critical appraisal of quality. The study protocol was registered on Prospero (CRD42021254970).Fifty out of 4 334 studies were eligible for inclusion in this review. Ninety per cent of studies were of low quality. A total of 60 biomarkers were identified, with 24 in two or more studies and 15 in five or more studies. There was variation in reported units, normal range, and cut-off values. Meta-analysis was not possible due to study heterogeneity. Biomarkers currently recommended by the European Journal of Vascular and Endovascular Surgery, European Society for Trauma and Emergency Surgery 2016, and World Society of Emergency Surgery 2017 guidelines also had heterogeneous low quality data for use in the diagnosis of AMI.This systematic review shows high heterogeneity and low quality of the available evidence on biomarkers for arterial occlusive AMI. No clinical conclusions can be drawn on a biomarker or combination of biomarkers for patients suspected of arterial occlusive AMI. Restraint is advised when rejecting or determining AMI solely based on biomarkers.Copyright © 2023. Published by Elsevier B.V.

Citation

Juliëtte T M Blauw, Flores M Metz, Alexandre Nuzzo, Faridi S van Etten-Jamaludin, Marjolein Brusse-Keizer, Marja A Boermeester, Maikel Peppelenbosch, Robert H Geelkerken, Dutch Mesenteric Ischaemia Study group. The Diagnostic Value of Biomarkers in Acute Mesenteric Ischaemia Is Insufficiently Substantiated: A Systematic Review. European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery. 2023 Aug 26

PMID: 37640253

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