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dc.contributor.authorKintu-Luwaga, Ronald
dc.contributor.authorGalukande, Moses
dc.contributor.authorOwori, Francis N
dc.date.accessioned2015-06-25T06:40:58Z
dc.date.available2015-06-25T06:40:58Z
dc.date.issued2013
dc.identifier.citationKintu-Luwaga, R. et al. (2013). Serum lactate and phosphate as biomarkers of intestinal ischemia in a Ugandan tertiary hospital: A cross sectional study. International Journal of Emergency Medicine, 6(44): 1-7en_US
dc.identifier.issn1865-1380
dc.identifier.otherdoi:10.1186/1865-1380-6-44
dc.identifier.urihttp://hdl.handle.net/10570/4482
dc.description.abstractAbstract Background: Intestinal ischemia is a common complication of intestinal obstruction and arises from impaired perfusion. The resultant local and systemic inflammatory response and bacterial translocation come with a significant degree of morbidity and mortality. This study therefore aimed to investigate the predictive value of elevated levels of serum lactate and phosphate as biomarkers of intestinal ischemia among patients with mechanical intestinal obstruction. Methods: This was a cross-sectional analytical study done at Mulago Hospital in Uganda. Ethical approval was obtained. All eligible patients had a blood sample drawn for assay analysis. Determination of bowel ischemia status was by physical examination at laparotomy. Analyses were performed using Stata software, version 10.1, and 2 × 2 tables were used to calculate sensitivity and specificity. Results: Serum lactate was predictive of bowel ischemia, while phosphate was not. Of the 81 patients enrolled 70 qualified for analysis; 40/70 (57%) had ischemic bowel, while 30/70 (43%) had normal bowel. Among those with ischemic bowel, 28/40 (70%) had reversible ischemia, and 12/40 (30%) had irreversible ischemia. Serum lactate assay had a sensitivity of 66% and specificity of 53% for bowel ischemia in general and a higher sensitivity of 71% and specificity of 80% for irreversible bowel ischemia. Lactate was predictive of bowel ischemia in general (p = 0.011), PPV = 14%, but more significantly predictive of irreversible ischemia (p = 0.009), PPV = 42%. NPV for lactate in both forms of ischemia was 93%. Hernias (33/70, 47%) were the most common cause of intestinal obstruction. Conclusion: Serum lactate assay had moderate sensitivity for bowel ischemia due to acute mechanical intestinal obstruction. The assay can be used to aid diagnosis of bowel ischemia in low technology settings. Keywords: Bowel ischemia; Biomarkers; Serum lactate; Phosphateen_US
dc.description.sponsorshipTHRiVE (Training Health Researchers in Vocational Excellence in East Africa).en_US
dc.language.isoenen_US
dc.publisherSpringeren_US
dc.subjectBowel ischemiaen_US
dc.subjectBiomarkersen_US
dc.subjectSerum lactateen_US
dc.subjectPhosphateen_US
dc.titleSerum lactate and phosphate as biomarkers of intestinal ischemia in a Ugandan tertiary hospital: aA cross-sectional study.en_US
dc.typeJournal articleen_US


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