Blunt Abdominal Trauma in Adults: A Score to Predict the Absence of Organ Injury.

Bongers, M.E.R. (2014) Blunt Abdominal Trauma in Adults: A Score to Predict the Absence of Organ Injury. thesis, Medicine.

Text BongersM.pdf Restricted to Registered users only Download (873kB)

Abstract

Objective: The aim of this study is to generate a scoring system to identify and/or rule out the presence of intra-abdominal organ injury in trauma patients with blunt abdominal trauma, without the use of CT scan. The scoring system will be designed in such a manner that it can be performed in the Emergency room (ER) using the same data collected during initial trauma care, so it will not interfere with the ATLS protocol. Methods: This retrospective study included all patients aged >16 years that were categorized as a so-called A-trauma by the paramedical team and subsequently admitted to the UMCG. All parameters needed for this study were extracted from the EPD. A multivariate logistic regression was performed with the covariates: Free fluid in the abdomen on FAST, Sex, Age, ALAT, Hemoglobin, Creatinine, Base Excess, Amylase, Fibrinogen, INR, LDH and Shock Index to identify predictors for the presence of abdominal injury. Results: Free fluid on FAST, Shock Index, Creatinine, INR and LDH are the best predictors for the presence of abdominal injury. These predictors were combined to generate the BATiA-score. Free fluid on FAST is highly suggestive for the presence of abdominal injury with an odds ratio of: 416,297. The ABAT score was also generated and after a multiple logistic regression: Creatinine, LDH, Shock Index, Sex, ALAT and Hemoglobin seem to be the best predictors for the presence of abdominal injury in a setting where no sonographic scanner is available. Conclusions: A score to predict the presence of abdominal injury (BATiA) was generated, free fluid on FAST proved to be highly predictive for the presence of abdominal injury and comprised the major part of the score. Therefore, we suggest that the FAST procedure is performed in every trauma patient admitted to the ER, only with a positive result of the FAST further abdominal CT-scanning should be performed. The ABAT proved to be a promising score for institutions where no sonographic scanners are available. Further research has to be done to improve and validate this score to be a helpful aid in third world countries.

Item Type:	Thesis (Thesis)
Supervisor name:	Hulscher, J.B.F. MD/PhD and Department of Surgery and University Medical Centre Groningen and University of Groningen
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:51
Last Modified:	25 Jun 2020 10:51
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1179

Actions (login required)

View Item