Validation of a score chart to predict the risk of chronic mesenteric ischemia and development of an updated score chart

Louisa J. D. van Dijk*, Desiree van Noord, Robert H. Geelkerken, Jihan Harki, Sophie A. Berendsen, Annemarie C. de Vries, Adriaan Moelker, Yvonne Vergouwe, Hence J. M. Verhagen, Jeroen J. Kolkman, Marco J. Bruno, Ron Balm, Gert Jan de Borst, Juliette T. Blauw, Olaf J. Bakker, Hessel C. J. L. Buscher, Bram Fioole, Jaap F. Hamming, Daniel A. F. van den Heuvel, Eline S. van HattumJan Willem Hinnen, Maarten J. van der Laan, Kaatje Lenaerts, Maikel P. Peppelenbosch, Andre S. van Petersen, Pepijn Rijnja, Peter J. van der Schaar, Luke G. Terlouw, Jean Paul P. M. de Vries, Dammis Vroegindeweij, Dutch Mesenteric Ischemia Study group (DMIS)

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background and objective: The objective of this article is to externally validate and update a recently published score chart for chronic mesenteric ischemia (CMI). Methods: A multicenter prospective cohort analysis was conducted of 666 CMI-suspected patients referred to two Dutch specialized CMI centers. Multidisciplinary consultation resulted in expert-based consensus diagnosis after which CMI consensus patients were treated. A definitive diagnosis of CMI was established if successful treatment resulted in durable symptom relief. The absolute CMI risk was calculated and discriminative ability of the original chart was assessed by the c-statistic in the validation cohort. Thereafter the original score chart was updated based on the performance in the combined original and validation cohort with inclusion of celiac artery (CA) stenosis cause. Results: In 8% of low-risk patients, 39% of intermediate-risk patients and 94% of high-risk patients of the validation cohort, CMI was diagnosed. Discriminative ability of the original model was acceptable (c-statistic 0.79). The total score of the updated chart ranged from 0 to 28 points (low risk 19% absolute CMI risk, intermediate risk 45%, and high risk 92%). The discriminative ability of the updated chart was slightly better (c-statistic 0.80). Conclusion: The CMI prediction model performs and discriminates well in the validation cohort. The updated score chart has excellent discriminative ability and is useful in clinical decision making.

Original languageEnglish
Pages (from-to)1261-1270
Number of pages10
JournalUnited European Gastroenterology Journal
Issue number9
Publication statusPublished - Nov 2019


  • Angiography
  • atherosclerosis
  • celiac artery
  • chronic mesenteric ischemia
  • computed tomography magnetic resonance angiography
  • median arcuate ligament syndrome
  • prediction model
  • superior mesenteric artery
  • CT

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