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The Combination of d-Dimer and Peritoneal Irritation Signs as a Potential Indicator to Exclude the Diagnosis of Intestinal Necrosis
Intestinal necrosis is a life-threatening disease, and its prompt and accurate diagnosis is very important. This study aimed to evaluate the value of d-dimer as a marker for early diagnosis of bowel necrosis. From 2009 to 2013, patients undergoing operation due to acute intestinal obstruction were r...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4616729/ https://www.ncbi.nlm.nih.gov/pubmed/26448003 http://dx.doi.org/10.1097/MD.0000000000001564 |
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author | Yang, Kun Wang, Wei Zhang, Wei-Han Chen, Xiao-Long Zhou, Jing Chen, Xin-Zu Zhang, Bo Chen, Zhi-Xin Zhou, Zong-Guang Hu, Jian-Kun |
author_facet | Yang, Kun Wang, Wei Zhang, Wei-Han Chen, Xiao-Long Zhou, Jing Chen, Xin-Zu Zhang, Bo Chen, Zhi-Xin Zhou, Zong-Guang Hu, Jian-Kun |
author_sort | Yang, Kun |
collection | PubMed |
description | Intestinal necrosis is a life-threatening disease, and its prompt and accurate diagnosis is very important. This study aimed to evaluate the value of d-dimer as a marker for early diagnosis of bowel necrosis. From 2009 to 2013, patients undergoing operation due to acute intestinal obstruction were retrospectively analyzed. Clinicopathologic characteristics were compared among no ischemia group, reversible ischemia group, and bowel necrosis group. There were totally 274 patients being included for analyses. Patients with bowel necrosis had a significant highest level of d-dimer compared with other 2 groups (P = 0.007) when FEU unit was applied. The optimal cutoff value of d-dimer levels as an indicator in diagnosing bowel necrosis was projected to be 1.965 mg/L, which yielded a sensitivity of 84.0%, a specificity of 45.6%, a positive predictive value of 60.7%, and a negative predictive value of 74.0%. And the sensitivity of 84.0% and specificity of 70.0% were detected, when 1.65 mg/L of d-dimer was set as the cutoff value to distinguish the reversible ischemia and bowel necrosis. The corresponding results in patients with no or slight peritoneal irritation signs were 85.2%, 44.7%, 35.4% and 89.5% respectively. The sensitivity and negative predictive value were 96.0% and 91.7%, respectively, when d-dimer and peritoneal irritation signs were combined to perform the parallel analysis. The combination of d-dimer and peritoneal irritation signs could generate a reliable negative predictive value, which is helpful to exclude the diagnosis of intestinal necrosis. However, it should also be proved in well-designed large-scale prospective study. |
format | Online Article Text |
id | pubmed-4616729 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-46167292015-10-27 The Combination of d-Dimer and Peritoneal Irritation Signs as a Potential Indicator to Exclude the Diagnosis of Intestinal Necrosis Yang, Kun Wang, Wei Zhang, Wei-Han Chen, Xiao-Long Zhou, Jing Chen, Xin-Zu Zhang, Bo Chen, Zhi-Xin Zhou, Zong-Guang Hu, Jian-Kun Medicine (Baltimore) 7100 Intestinal necrosis is a life-threatening disease, and its prompt and accurate diagnosis is very important. This study aimed to evaluate the value of d-dimer as a marker for early diagnosis of bowel necrosis. From 2009 to 2013, patients undergoing operation due to acute intestinal obstruction were retrospectively analyzed. Clinicopathologic characteristics were compared among no ischemia group, reversible ischemia group, and bowel necrosis group. There were totally 274 patients being included for analyses. Patients with bowel necrosis had a significant highest level of d-dimer compared with other 2 groups (P = 0.007) when FEU unit was applied. The optimal cutoff value of d-dimer levels as an indicator in diagnosing bowel necrosis was projected to be 1.965 mg/L, which yielded a sensitivity of 84.0%, a specificity of 45.6%, a positive predictive value of 60.7%, and a negative predictive value of 74.0%. And the sensitivity of 84.0% and specificity of 70.0% were detected, when 1.65 mg/L of d-dimer was set as the cutoff value to distinguish the reversible ischemia and bowel necrosis. The corresponding results in patients with no or slight peritoneal irritation signs were 85.2%, 44.7%, 35.4% and 89.5% respectively. The sensitivity and negative predictive value were 96.0% and 91.7%, respectively, when d-dimer and peritoneal irritation signs were combined to perform the parallel analysis. The combination of d-dimer and peritoneal irritation signs could generate a reliable negative predictive value, which is helpful to exclude the diagnosis of intestinal necrosis. However, it should also be proved in well-designed large-scale prospective study. Wolters Kluwer Health 2015-10-09 /pmc/articles/PMC4616729/ /pubmed/26448003 http://dx.doi.org/10.1097/MD.0000000000001564 Text en Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms. http://creativecommons.org/licenses/by-nc-sa/4.0 |
spellingShingle | 7100 Yang, Kun Wang, Wei Zhang, Wei-Han Chen, Xiao-Long Zhou, Jing Chen, Xin-Zu Zhang, Bo Chen, Zhi-Xin Zhou, Zong-Guang Hu, Jian-Kun The Combination of d-Dimer and Peritoneal Irritation Signs as a Potential Indicator to Exclude the Diagnosis of Intestinal Necrosis |
title | The Combination of d-Dimer and Peritoneal Irritation Signs as a Potential Indicator to Exclude the Diagnosis of Intestinal Necrosis |
title_full | The Combination of d-Dimer and Peritoneal Irritation Signs as a Potential Indicator to Exclude the Diagnosis of Intestinal Necrosis |
title_fullStr | The Combination of d-Dimer and Peritoneal Irritation Signs as a Potential Indicator to Exclude the Diagnosis of Intestinal Necrosis |
title_full_unstemmed | The Combination of d-Dimer and Peritoneal Irritation Signs as a Potential Indicator to Exclude the Diagnosis of Intestinal Necrosis |
title_short | The Combination of d-Dimer and Peritoneal Irritation Signs as a Potential Indicator to Exclude the Diagnosis of Intestinal Necrosis |
title_sort | combination of d-dimer and peritoneal irritation signs as a potential indicator to exclude the diagnosis of intestinal necrosis |
topic | 7100 |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4616729/ https://www.ncbi.nlm.nih.gov/pubmed/26448003 http://dx.doi.org/10.1097/MD.0000000000001564 |
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