ArticleAnnals of intensive care2018
Biological scoring system for early prediction of acute bowel ischemia after cardiac surgery: the PALM score.
Article in Annals of intensive care, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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11 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Diagnostic accuracy of biomarkers to detect acute mesenteric ischaemia in adult patients: a systematic review and meta-analysis.World journal of emergency surgery : WJES · 2023Pooled it
- Advancing precision triage in strangulated small bowel obstruction: from static scores to dynamic multiparametric models.Frontiers in surgery · 2026Review
- Selective visceral perfusion in thoracoabdominal aortic surgery: optimal flow rate in a porcine model.Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs · 2025Article
- The role of serum vaspin level in the early diagnosis of mesenteric ischemia induced in experimental animal model.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- An engineered poly(A) tail attenuates gut ischemia/reperfusion-induced acute lung injury.Surgery · 2024Article
- Gastrointestinal complications after cardiac surgery.Trauma surgery & acute care open · 2024Review
- Anatomic risk factors for the occurrence of medial talar osteochondral lesions: a case-control study.Skeletal radiology · 2022Article
- Role of clinical data and multidetector computed tomography findings in acute superior mesenteric artery embolism.World journal of clinical cases · 2022Article
- Association of Serum Creatinine Level with Prognosis of Laparotomy for Acute Mesenteric Ischemia after Cardiovascular Surgery.Surgery research and practice · 2022Article
- The relationship of systemic inflammatory biomarkers and cardiac parameters with malignancy in patients with soft tissue tumors located in the extremity.Joint diseases and related surgery · 2021Article
- Risk factors of geriatrics index of comorbidity and MDCT findings for predicting mortality in patients with acute mesenteric ischemia due to superior mesenteric artery thromboembolism.The British journal of radiology · 2020Article
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Authors and funding
16 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBowel ischemia is a life-threatening emergency defined as an inadequate vascular perfusion leading to bowel inflammation resulting from impaired colonic/small bowel blood supply. Main issue for physicians regarding bowel ischemia diagnosis lies in the absence of informative and specific clinical or biological signs leading to delayed management, resulting in a poorer prognosis, especially after cardiac surgery. The aim of the present series was to propose a simple scoring system based on biological data for the diagnosis of bowel ischemia.
methodsIn a retrospective monocentric study, patients admitted in cardiac ICU, after cardiovascular surgery, were screened for inclusion. According to a 1:2 ratio (case-control), matching between two groups was based on sex, type of cardiovascular surgery, and the operative period (per month). Patients were divided into two groups: "ischemic group" which corresponds to patients with confirmed bowel ischemia and "non-ischemic group" which corresponds to patients without bowel ischemia. Primary objective was the conception of a scoring system for the diagnosis of bowel ischemia. Secondary objectives were to detail the postoperative morbidity and the diagnostic features for the distinction between acute mesenteric ischemia and ischemic colitis.
resultsForty-eight patients (1.3%) had confirmed bowel ischemia ("ischemic group"). According to the 2:1 matching, 96 patients were included in the "non-ischemic group." Aspartate aminotransferase > 449 UI/L, lactate > 4 mmol/L, procalcitonin > 4.7 μg/L, and myoglobin > 1882 μg/L were found to be independently associated with bowel ischemia. Based on their respective odds ratios, points were assigned to each item ranging from 4 to 8. AUROCC [95% confidence interval] of the scoring system to diagnose bowel ischemia was 0.93 [0.91-0.95], p < 0.001. The optimal threshold after bootstrapping was ≥ 14 points; this yielded a sensitivity of 85.4%, a specificity of 94.8%, a positive likelihood ratio of 16.42, a negative likelihood ratio of 0.15, a Youden's index of 0.802, and a diagnostic odds ratio of 106.62.
conclusionsA biological scoring system based on PCT, ASAT, lactate, and myoglobin measurement allows the diagnosis of bowel ischemia after cardiac surgery with high accuracy. This score could help clinician to propose an early diagnosis and an early treatment in this high mortality disease.
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