title: Serum ischaemia-modified albumin increases in critical lower limb ischaemia.
abstract: BACKGROUND
  Ischaemia is a common phenomenon in the pathogenesis of a wide range of medical and surgical conditions, including myocardial infarction, mesenteric vascular occlusion and compartment syndrome. Ischaemia modified albumin has been suggested as an aid to clinical decision making in various clinical settings. This study examines the usefulness of IMA in the diagnosis of limb ischaemia (LI).
  
  
  METHODS
  This case-controlled study was performed in the emergency department of Karadeniz Technical University Hospital, Turkey. 22 patients presenting to the emergency departments and definitively diagnosed with LI were enrolled in the study. A control group of 22 healthy volunteers served as a reference for biochemical parameters.
  
  
  RESULTS
  The mean serum IMA level for LI patients was 0.295 (SD 0.062) ABSU. The mean serum IMA level for control patients was 0.174 (SD 0.061) ABSU. There was a statistically significant difference between the mean LI patient and mean control patient IMA levels (p<0.0005). A ROC curve analysis reveals the relationship between sensitivity and specificity for IMA in limb ischaemia.
  
  
  CONCLUSIONS
  There is a significant increase in serum IMA in limb ischaemia. Furthermore, using a cutoff of 0.22 ABSU, ROC curve analysis shows that IMA is 81.8% sensitive and 81.8% specific 81.8% in patients with clinically severe lower limb ischaemia. Future studies would be needed to determine if IMA would be clinically useful in the diagnosis of subtle limb ischaemia.
authors.affiliation: Department of Emergency Medicine, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey. gunduzkadir@hotmail.com
authors.forename: A
authors.initials: A
authors.lastname: Gunduz
authors.forename: A
authors.initials: A
authors.lastname: Mentese
authors.forename: S
authors.initials: S
authors.lastname: Turedi
authors.forename: S C
authors.initials: SC
authors.lastname: Karahan
authors.forename: U
authors.initials: U
authors.lastname: Mentese
authors.forename: O
authors.initials: O
authors.lastname: Eroglu
authors.forename: S
authors.initials: S
authors.lastname: Turkmen
authors.forename: I
authors.initials: I
authors.lastname: Turan
authors.forename: U
authors.initials: U
authors.lastname: Ucar
authors.forename: R
authors.initials: R
authors.lastname: Russell
authors.forename: F
authors.initials: F
authors.lastname: Balaban
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D004636:Emergency Service, Hospital; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007511:Ischemia / Q000097:blood / Q000175:diagnosis*; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D012709:Serum Albumin / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D012709:Serum Albumin