Early diagnosis of hollow viscus injury using intestinal fatty acid-binding protein in blunt trauma patients

Shokei Matsumoto, Kazuhiko Sekine, Hiroyuki Funaoka, Tomohiro Funabiki, Masayuki Shimizu, Kei Hayashida, Mitsuhide Kitano

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

A delay in diagnosing hollow viscus injury (HVI) causes an increase in mortality and morbidity. HVI remains a challenge to diagnose, and there is no specific diagnostic biomarker for HVI. We evaluated the utility of intestinal fatty acid-binding protein (I-FABP) in diagnosing HVI in blunt trauma patients. Within a 5-year period, 93 consecutive patients with clinically suspected HVI at our trauma center were prospectively enrolled. The diagnostic performance of I-FABP for HVI was compared with that of other various parameters (physical, laboratory, and radiographic findings). HVI was diagnosed in 13 patients (14%), and non-HVI was diagnosed in 80 patients (86%). The level of I-FABP was significantly higher in patients with HVI than in those with non-HVI (P=0.014; area under the curve, 0.71). The sensitivity, specificity, positive predictive value, and negative predictive value were 76.9%, 70.0%, 29.4%, and 94.9%, respectively (P=0.003). However, all other biomarkers were not significantly different between the groups. Presence of extraluminal air, bowel wall thickening on computed tomography (CT), and peritonitis signs were significantly higher in patients with HVI (P<0.05). Of 49 patients (52.7%) who had a negative I-FABP and negative peritonitis signs, none developed HVI (sensitivity, 100%; negative predictive value, 100%). This is the first study that demonstrated the diagnostic value of a biomarker for HVI. I-FABP has a higher negative predictive value compared to traditional diagnostic tests. Although the accuracy of I-FABP alone was insufficient, the combination of I-FABP and other findings can enhance diagnostic ability.

Original languageEnglish
Article numbere6187
JournalMedicine (United States)
Volume96
Issue number10
DOIs
Publication statusPublished - 2017 Mar 1
Externally publishedYes

Fingerprint

Fatty Acid-Binding Proteins
Viscera
Early Diagnosis
Wounds and Injuries
Biomarkers
Peritonitis
Nonpenetrating Wounds
Trauma Centers
Routine Diagnostic Tests
Area Under Curve

Keywords

  • blunt abdominal trauma
  • diagnosis
  • hollow viscus injury
  • intestinal fatty acid binding protein

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Matsumoto, S., Sekine, K., Funaoka, H., Funabiki, T., Shimizu, M., Hayashida, K., & Kitano, M. (2017). Early diagnosis of hollow viscus injury using intestinal fatty acid-binding protein in blunt trauma patients. Medicine (United States), 96(10), [e6187]. https://doi.org/10.1097/MD.0000000000006187

Early diagnosis of hollow viscus injury using intestinal fatty acid-binding protein in blunt trauma patients. / Matsumoto, Shokei; Sekine, Kazuhiko; Funaoka, Hiroyuki; Funabiki, Tomohiro; Shimizu, Masayuki; Hayashida, Kei; Kitano, Mitsuhide.

In: Medicine (United States), Vol. 96, No. 10, e6187, 01.03.2017.

Research output: Contribution to journalArticle

Matsumoto, S, Sekine, K, Funaoka, H, Funabiki, T, Shimizu, M, Hayashida, K & Kitano, M 2017, 'Early diagnosis of hollow viscus injury using intestinal fatty acid-binding protein in blunt trauma patients', Medicine (United States), vol. 96, no. 10, e6187. https://doi.org/10.1097/MD.0000000000006187
Matsumoto, Shokei ; Sekine, Kazuhiko ; Funaoka, Hiroyuki ; Funabiki, Tomohiro ; Shimizu, Masayuki ; Hayashida, Kei ; Kitano, Mitsuhide. / Early diagnosis of hollow viscus injury using intestinal fatty acid-binding protein in blunt trauma patients. In: Medicine (United States). 2017 ; Vol. 96, No. 10.
@article{1b552f1d9e6043049bc7fc9d8f3da985,
title = "Early diagnosis of hollow viscus injury using intestinal fatty acid-binding protein in blunt trauma patients",
abstract = "A delay in diagnosing hollow viscus injury (HVI) causes an increase in mortality and morbidity. HVI remains a challenge to diagnose, and there is no specific diagnostic biomarker for HVI. We evaluated the utility of intestinal fatty acid-binding protein (I-FABP) in diagnosing HVI in blunt trauma patients. Within a 5-year period, 93 consecutive patients with clinically suspected HVI at our trauma center were prospectively enrolled. The diagnostic performance of I-FABP for HVI was compared with that of other various parameters (physical, laboratory, and radiographic findings). HVI was diagnosed in 13 patients (14{\%}), and non-HVI was diagnosed in 80 patients (86{\%}). The level of I-FABP was significantly higher in patients with HVI than in those with non-HVI (P=0.014; area under the curve, 0.71). The sensitivity, specificity, positive predictive value, and negative predictive value were 76.9{\%}, 70.0{\%}, 29.4{\%}, and 94.9{\%}, respectively (P=0.003). However, all other biomarkers were not significantly different between the groups. Presence of extraluminal air, bowel wall thickening on computed tomography (CT), and peritonitis signs were significantly higher in patients with HVI (P<0.05). Of 49 patients (52.7{\%}) who had a negative I-FABP and negative peritonitis signs, none developed HVI (sensitivity, 100{\%}; negative predictive value, 100{\%}). This is the first study that demonstrated the diagnostic value of a biomarker for HVI. I-FABP has a higher negative predictive value compared to traditional diagnostic tests. Although the accuracy of I-FABP alone was insufficient, the combination of I-FABP and other findings can enhance diagnostic ability.",
keywords = "blunt abdominal trauma, diagnosis, hollow viscus injury, intestinal fatty acid binding protein",
author = "Shokei Matsumoto and Kazuhiko Sekine and Hiroyuki Funaoka and Tomohiro Funabiki and Masayuki Shimizu and Kei Hayashida and Mitsuhide Kitano",
year = "2017",
month = "3",
day = "1",
doi = "10.1097/MD.0000000000006187",
language = "English",
volume = "96",
journal = "Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries",
issn = "0025-7974",
publisher = "Lippincott Williams and Wilkins",
number = "10",

}

TY - JOUR

T1 - Early diagnosis of hollow viscus injury using intestinal fatty acid-binding protein in blunt trauma patients

AU - Matsumoto, Shokei

AU - Sekine, Kazuhiko

AU - Funaoka, Hiroyuki

AU - Funabiki, Tomohiro

AU - Shimizu, Masayuki

AU - Hayashida, Kei

AU - Kitano, Mitsuhide

PY - 2017/3/1

Y1 - 2017/3/1

N2 - A delay in diagnosing hollow viscus injury (HVI) causes an increase in mortality and morbidity. HVI remains a challenge to diagnose, and there is no specific diagnostic biomarker for HVI. We evaluated the utility of intestinal fatty acid-binding protein (I-FABP) in diagnosing HVI in blunt trauma patients. Within a 5-year period, 93 consecutive patients with clinically suspected HVI at our trauma center were prospectively enrolled. The diagnostic performance of I-FABP for HVI was compared with that of other various parameters (physical, laboratory, and radiographic findings). HVI was diagnosed in 13 patients (14%), and non-HVI was diagnosed in 80 patients (86%). The level of I-FABP was significantly higher in patients with HVI than in those with non-HVI (P=0.014; area under the curve, 0.71). The sensitivity, specificity, positive predictive value, and negative predictive value were 76.9%, 70.0%, 29.4%, and 94.9%, respectively (P=0.003). However, all other biomarkers were not significantly different between the groups. Presence of extraluminal air, bowel wall thickening on computed tomography (CT), and peritonitis signs were significantly higher in patients with HVI (P<0.05). Of 49 patients (52.7%) who had a negative I-FABP and negative peritonitis signs, none developed HVI (sensitivity, 100%; negative predictive value, 100%). This is the first study that demonstrated the diagnostic value of a biomarker for HVI. I-FABP has a higher negative predictive value compared to traditional diagnostic tests. Although the accuracy of I-FABP alone was insufficient, the combination of I-FABP and other findings can enhance diagnostic ability.

AB - A delay in diagnosing hollow viscus injury (HVI) causes an increase in mortality and morbidity. HVI remains a challenge to diagnose, and there is no specific diagnostic biomarker for HVI. We evaluated the utility of intestinal fatty acid-binding protein (I-FABP) in diagnosing HVI in blunt trauma patients. Within a 5-year period, 93 consecutive patients with clinically suspected HVI at our trauma center were prospectively enrolled. The diagnostic performance of I-FABP for HVI was compared with that of other various parameters (physical, laboratory, and radiographic findings). HVI was diagnosed in 13 patients (14%), and non-HVI was diagnosed in 80 patients (86%). The level of I-FABP was significantly higher in patients with HVI than in those with non-HVI (P=0.014; area under the curve, 0.71). The sensitivity, specificity, positive predictive value, and negative predictive value were 76.9%, 70.0%, 29.4%, and 94.9%, respectively (P=0.003). However, all other biomarkers were not significantly different between the groups. Presence of extraluminal air, bowel wall thickening on computed tomography (CT), and peritonitis signs were significantly higher in patients with HVI (P<0.05). Of 49 patients (52.7%) who had a negative I-FABP and negative peritonitis signs, none developed HVI (sensitivity, 100%; negative predictive value, 100%). This is the first study that demonstrated the diagnostic value of a biomarker for HVI. I-FABP has a higher negative predictive value compared to traditional diagnostic tests. Although the accuracy of I-FABP alone was insufficient, the combination of I-FABP and other findings can enhance diagnostic ability.

KW - blunt abdominal trauma

KW - diagnosis

KW - hollow viscus injury

KW - intestinal fatty acid binding protein

UR - http://www.scopus.com/inward/record.url?scp=85015945274&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85015945274&partnerID=8YFLogxK

U2 - 10.1097/MD.0000000000006187

DO - 10.1097/MD.0000000000006187

M3 - Article

VL - 96

JO - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries

JF - Medicine; analytical reviews of general medicine, neurology, psychiatry, dermatology, and pediatries

SN - 0025-7974

IS - 10

M1 - e6187

ER -