Abstract
Numerous studies have investigated the utility of serum intestinal fatty-acid binding protein (I-FABP) in differentiating acute intestinal ischemia from acute abdomen. However, the results remain controversial. The aim of this meta-analysis is to determine the overall accuracy of serum I-FABP in the diagnosis of acute intestinal ischemia. Publications addressing the accuracy of serum I-FABP in the diagnosis of ischemic bowel diseases were selected from databases. The values of true-positive (TP), true-negative (TN), false-positive (FP), and false-negative (FN) were extracted or calculated for each study. Pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were calculated. The overall diagnostic performance was assessed using a summary receiver operating characteristic curve (SROC) and area under curve (AUC). Nine studies that collectively included 1246 patients met the eligible criteria. The pooled sensitivity, specificity, DOR, PLR, and NLR were 0.80 (95% CI: 0.72–0.86), 0.85 (95% CI: 0.73–0.93), 24 (95% CI: 9–65), 5.5 (95% CI: 2.8–10.8) and 0.23 (95% CI: 0.15–0.35), respectively. The AUC was 0.86 (95% CI: 0.83–0.89). The meta-analysis carried out in this report suggests that the I-FABP may be a useful diagnostic tool to confirm acute intestinal ischemia in acute abdomen, but better-designed trials are still required to confirm our findings.
Highlights
Exclusion criteria: (1) studies did not report sensitivity or specificity of intestinal fatty-acid binding protein (I-FABP); (2) studies did not report the definition of reference standards for diagnosis of intestinal ischemia; (3) studies included methodological mistakes
Among the 15 excluded papers, 12 studies did not report sensitivity or specificity of I-FABP9,18,20,26–34, one study was a duplicate[35], one study did not report the definition of reference standard for diagnosis[36] and one study had methodological inaccuracies[37]
The pooled sensitivity and specificity of serum I-FABP for the detection of acute intestinal ischemia were 0.80
Summary
Exclusion criteria: (1) studies did not report sensitivity or specificity of I-FABP; (2) studies did not report the definition of reference standards for diagnosis of intestinal ischemia; (3) studies included methodological mistakes. Among the 15 excluded papers, 12 studies did not report sensitivity or specificity of I-FABP9,18,20,26–34, one study was a duplicate[35], one study did not report the definition of reference standard for diagnosis[36] and one study had methodological inaccuracies[37]. 1246 patients with suspected acute intestinal ischemia were included in this meta-analysis.
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