Normal Lactate and Unenhanced CT-Scan Result in Delayed Diagnosis of Acute Mesenteric Ischemia
Alexandre Nuzzo, Francisca Joly, Maxime Ronot, Yves Castier, Audrey Payancé, Cathérine Paugam‐Burtz, Dominique Cazals‐Hatem, Alexy Tran‐Dinh, Aymeric Becq, Yves Panís, Yoram Bouhnik, Léon Maggiori, Olivier Corcos, on behalf of the SURVI group
Abstract
INTRODUCTION: To investigate the factors associated with a delayed diagnosis (DD) of acute mesenteric ischemia (AMI). METHODS: An observational cohort study from an intestinal failure center. The primary outcome was DD >24 hours. RESULTS: Between 2006 and 2015, 74 patients with AMI were included and 39 (53%) had a DD. Plasma lactate <2 mmol/L (odd ratio: 3.2; 95% confidence interval: 1.1-9.1; P = 0.03) and unenhanced computed tomography scan (odds ratio: 5.9; 95% confidence interval: 1.4-25.8; P = 0.01) were independently associated with DD. DISCUSSION: Suspicion of AMI should no longer be affected by normal plasma lactate levels and should prompt evaluation by a contrast-enhanced computed tomography-scan.