Universität zu Köln

ten Cate, Floris E. A. Udink, Hannes, Tobias ORCID: 0000-0002-8550-2282, Germund, Ingo, Khalil, Markus, Huntgeburth, Michael, Apitz, Christian, Brockmeier, Konrad and Sreeram, Narayanswami (2016). Towards a proposal for a universal diagnostic definition of protein-losing enteropathy in Fontan patients: a systematic review. Heart, 102 (14). S. 1115 - 1120. LONDON: BMJ PUBLISHING GROUP. ISSN 1468-201X

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Abstract

Objective A standardised diagnostic definition of protein-losing enteropathy (PLE) in Fontan patients serves both patient care and research. The present study determined whether a diagnostic definition of PLE was routinely used in published clinical Fontan studies, and to identify potentially relevant diagnostic criteria for composing a uniform PLE definition. Methods A systematic review was conducted in adherence to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) recommendations. Published clinical Fontan studies that were written in English and included at least four patients with PLE were selected. PLE definitions were quantitatively analysed using a lateral thinking tool in which definitions were fractionated into constituent pieces of information (building blocks or diagnostic criteria). Results We identified 364 papers. In the final analysis, data from 62 published articles were extracted. A diagnostic definition of PLE was used in only 27/62 (43.5%) of selected studies, and definitions were very heterogeneous. We identified eight major diagnostic criteria. Hypoalbuminaemia (n=23 studies, 85.2%), clinical presentation (n=18, 66.7%), documentation of enteric protein loss (n=16, 59.3%) and exclusion of other causes of hypoproteinaemia (n=17, 63.0%), were the most frequently used diagnostic criteria. Most studies used three diagnostic variables (n=13/27, 48.1%). Cutoff values for laboratory parameters (serum albumin, protein or faecal alpha-1-antitrypsin) were frequently incorporated in the PLE definition (n=16, 59.3%). Conclusions Establishment of a universally accepted PLE definition for routine use in clinical research and daily practice is required. The diagnostic criteria may help constitute a diagnostic PLE definition.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code ten Cate, Floris E. A. Udink UNSPECIFIED UNSPECIFIED UNSPECIFIED Hannes, Tobias UNSPECIFIED orcid.org/0000-0002-8550-2282 UNSPECIFIED Germund, Ingo UNSPECIFIED UNSPECIFIED UNSPECIFIED Khalil, Markus UNSPECIFIED UNSPECIFIED UNSPECIFIED Huntgeburth, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Apitz, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Brockmeier, Konrad UNSPECIFIED UNSPECIFIED UNSPECIFIED Sreeram, Narayanswami UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-271082
DOI:	10.1136/heartjnl-2015-308823
Journal or Publication Title:	Heart
Volume:	102
Number:	14
Page Range:	S. 1115 - 1120
Date:	2016
Publisher:	BMJ PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	1468-201X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language HEPATIC-FIBROSIS; OPERATION; CRITERIA; VALIDATION; LIVER Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/27108