title: Usefulness of intestinal fatty acid-binding protein in predicting strangulated small bowel obstruction.
abstract: BACKGROUND
  The level of intestinal fatty acid-binding protein (I-FABP) is considered to be useful diagnostic markers of small bowel ischemia. The purpose of this retrospective study was to investigate whether the serum I-FABP level is a predictive marker of strangulation in patients with small bowel obstruction (SBO).
  
  
  METHODS
  A total of 37 patients diagnosed with SBO were included in this study. The serum I-FABP levels were retrospectively compared between the patients with strangulation and those with simple obstruction, and cut-off values for the diagnosis of strangulation were calculated using a receiver operating characteristic curve. In addition, the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated.
  
  
  RESULTS
  Twenty-one patients were diagnosed with strangulated SBO. The serum I-FABP levels were significantly higher in the patients with strangulation compared with those observed in the patients with simple obstruction (18.5 vs. 1.6 ng/ml p<0.001). Using a cut-off value of 6.5 ng/ml, the sensitivity, specificity, PPV and NPV were 71.4%, 93.8%, 93.8% and 71.4%, respectively. An I-FABP level greater than 6.5 ng/ml was found to be the only independent significant factor for a higher likelihood of strangulated SBO (P =  0.02; odds ratio: 19.826; 95% confidence interval: 2.1560 - 488.300).
  
  
  CONCLUSIONS
  The I-FABP level is a useful marker for discriminating between strangulated SBO and simple SBO in patients with SBO.
authors.affiliation: Department of Emergency, Osaka Mishima Emergency Critical Care Center, Takatsuki, Osaka, Japan.
authors.forename: Hirotada
authors.initials: H
authors.lastname: Kittaka
authors.affiliation: Department of Emergency, Osaka Mishima Emergency Critical Care Center, Takatsuki, Osaka, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Akimoto
authors.affiliation: Department of Inspection, Osaka Mishima Emergency Critical Care Center, Takatsuki, Osaka, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Takeshita
authors.affiliation: DS Pharma Biomedical CO., Ltd, Suita, Osaka, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Funaoka
authors.affiliation: Department of Emergency, Osaka Mishima Emergency Critical Care Center, Takatsuki, Osaka, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hazui
authors.affiliation: Department of Emergency, Osaka Mishima Emergency Critical Care Center, Takatsuki, Osaka, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Okamoto
authors.affiliation: Department of Emergency, Osaka Mishima Emergency Critical Care Center, Takatsuki, Osaka, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kobata
authors.affiliation: Department of Emergency, Osaka Mishima Emergency Critical Care Center, Takatsuki, Osaka, Japan.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ohishi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D050556:Fatty Acid-Binding Proteins / Q000097:blood*; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000097:blood* / Q000175:diagnosis*; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; D050556:Fatty Acid-Binding Proteins