TY - JOUR
T1 - Validation of a score chart to predict the risk of chronic mesenteric ischemia and development of an updated score chart
AU - van Dijk, Louisa J. D.
AU - van Noord, Desiree
AU - Geelkerken, Robert H.
AU - Harki, Jihan
AU - Berendsen, Sophie A.
AU - de Vries, Annemarie C.
AU - Moelker, Adriaan
AU - Vergouwe, Yvonne
AU - Verhagen, Hence J. M.
AU - Kolkman, Jeroen J.
AU - Bruno, Marco J.
AU - Balm, Ron
AU - de Borst, Gert Jan
AU - Blauw, Juliette T.
AU - Bakker, Olaf J.
AU - Buscher, Hessel C. J. L.
AU - Fioole, Bram
AU - Hamming, Jaap F.
AU - van den Heuvel, Daniel A. F.
AU - van Hattum, Eline S.
AU - Hinnen, Jan Willem
AU - van der Laan, Maarten J.
AU - Lenaerts, Kaatje
AU - Peppelenbosch, Maikel P.
AU - van Petersen, Andre S.
AU - Rijnja, Pepijn
AU - van der Schaar, Peter J.
AU - Terlouw, Luke G.
AU - de Vries, Jean Paul P. M.
AU - Vroegindeweij, Dammis
AU - Dutch Mesenteric Ischemia Study group (DMIS)
N1 - Funding Information:
Author contributions include the following: Louisa J.D. van Dijk: collecting, interpreting and analyzing data, drafting the manuscript. Desirée van Noord: planning and conducting the study, interpreting data and critical revision of the manuscript. Robert H. Geelkerken: interpreting data and critical revision of the manuscript. Jihan Harki: collecting data and critical revision of the manuscript. Sophie A. Berendsen: collecting data and critical revision of the manuscript. Annemarie C. de Vries: critical revision of the manuscript. Adriaan Moelker: critical revision of the manuscript. Yvonne Vergouwe: statistics, interpreting and analyzing data and critical revision of the manuscript. Hence J.M. Verhagen: interpreting data and critical revision of the manuscript. Jeroen J. Kolkman: interpreting data and critical revision of the manuscript. Marco J. Bruno: planning and conducting the study, interpreting data and critical revision of the manuscript. All authors approved the final draft submitted. The Dutch Mesenteric Ischemia Study group (DMIS) consists of the following individuals: Ron Balm, Academic Medical Centre, Amsterdam; Gert Jan de Borst, University Medical Centre Utrecht, Utrecht; Juliette T. Blauw, Medisch Spectrum Twente, Enschede; Marco J. Bruno, Erasmus MC University Medical Center, Rotterdam; Olaf J. Bakker, St. Antonius Hospital, Nieuwegein; Louisa J.D. van Dijk, Erasmus MC University Medical Center, Rotterdam; Hessel C.J.L. Buscher, Gelre Hospitals, Apeldoorn; Bram Fioole, Maasstad Hospital, Rotterdam; Robert H. Geelkerken, Medisch Spectrum Twente, Enschede; Jaap F. Hamming, Leiden University Medical Center, Leiden; Jihan Harki, Erasmus MC University Medical Center, Rotterdam; Daniel A.F. van den Heuvel, St. Antonius Hospital, Nieuwegein; Eline S. van Hattum, University Medical Centre Utrecht, Utrecht; Jan Willem Hinnen, Jeroen Bosch Hospital, ’s‐Hertogenbosch; Jeroen J. Kolkman, Medisch Spectrum Twente, Enschede; Maarten J. van der Laan, University Medical Center Groningen, Groningen; Kaatje Lenaerts, Maastricht University Medical Center, Maastricht; Adriaan Moelker, Erasmus MC University Medical Center, Rotterdam; Desirée van Noord, Franciscus Gasthuis & Vlietland, Rotterdam; Maikel P. Peppelenbosch, Erasmus MC University Medical Center, Rotterdam; André S. van Petersen, Bernhoven Hospital, Uden; Pepijn Rijnja, Medisch Spectrum Twente, Enschede’ Peter J. van der Schaar, St. Antonius Hospital, Nieuwegein; Luke G. Terlouw, Erasmus MC University Medical Center, Rotterdam; Hence J.M. Verhagen, Erasmus MC University Medical Center, Rotterdam; Jean Paul P.M. de Vries, University Medical Center Groningen, Groningen; and Dammis Vroegindeweij, Maasstad Hospital, Rotterdam.
Publisher Copyright:
© Author(s) 2019.
PY - 2019/11
Y1 - 2019/11
N2 - 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.
AB - 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.
KW - Angiography
KW - atherosclerosis
KW - celiac artery
KW - chronic mesenteric ischemia
KW - computed tomography magnetic resonance angiography
KW - median arcuate ligament syndrome
KW - prediction model
KW - superior mesenteric artery
KW - CHRONIC GASTROINTESTINAL ISCHEMIA
KW - GASTRIC EXERCISE TONOMETRY
KW - VISIBLE-LIGHT SPECTROSCOPY
KW - DUPLEX ULTRASOUND
KW - MANAGEMENT
KW - DIAGNOSIS
KW - CT
KW - ANGIOGRAPHY
U2 - 10.1177/2050640619856765
DO - 10.1177/2050640619856765
M3 - Article
C2 - 31700639
SN - 2050-6406
VL - 7
SP - 1261
EP - 1270
JO - United European Gastroenterology Journal
JF - United European Gastroenterology Journal
IS - 9
ER -