Background: Acute mesenteric venous thrombosis (MVT) is rarely suspected as primary diagnosis in emergency departments and still carries an in-hospital mortality rate of above 20%.
Objectives: The aim of this study was to find differences in clinical and laboratory markers between patients with acute MVT and a control group of suspected but confirmed as not having any type of acute mesenteric ischaemia (AMI).
Design: Data was retrieved from the AMESI (Acute MESenteric Ischaemia) study. This international, multicenter prospective case-control study from 32 sites collected data on patients with suspected AMI during a 10-month period.
Methods: Independent factors associated with acute MVT were evaluated in a multivariable logistic regression analysis and expressed as odds ratios (OR) with 95% confidence intervals (CI).
Results: D-dimer was not significantly higher in MVT (n = 73) compared to non-AMI (n = 287) patients (median 7.0 mg/L vs 4.5 mg/L, P = .092). After entering BMI, atherosclerotic disease, history of venous thromboembolism, CRP, and D-dimer as covariates in a multi-variable logistic regression analysis, absence of atherosclerotic disease (OR 0.096, 95% CI 0.011-0.84; P = .034) and elevated D-dimer (OR 2.59/one SD increment, 95% CI 1.07-6.28; P = .034) were associated with MVT. The discriminative ability of D-dimer for MVT as assessed by area under the curve in the receiver operating characteristics analysis was 0.63 (95% CI 0.49-0.78).
Conclusion: Elevated D-dimer was associated with MVT, but the discriminative ability of D-dimer was poor. There is an urgent need to find a more accurate plasma biomarker for this condition.
Trial registration: NCT05218863 (registered 19.01.2022).
Keywords: D-dimer; Mesenteric venous thrombosis; diagnosis; suspected acute mesenteric ischaemia.
Acute mesenteric vein thrombosis is rare, but life-threatening. The symptoms are abdominal pain and are not distinct from other acute abdominal conditions. A blood test identifying or leading to easier diagnosis is warranted. This multicenter international study has included patients with thrombosis in the mesenteric veins as well as suspected diseases, but not confirmed conditions, of disturbed circulation to the gastrointestinal tract. Elevation of the blood marker D-dimer was found to be associated with the condition of acute mesenteric vein thrombosis, but was not enough discriminative in relation to those patients with suspected disease only. There is an urgent need to find a more accurate blood marker for deep vein thrombosis of the abdomen.
© The Author(s) 2024.