FAST for blunt abdominal trauma: Correlation between positive findings and admission acid-base measurement
Abstract Purpose This study aimed to determine any association between positive findings in ultrasonography examination and initial BD value with regard to diagnosis of intra-abdominal bleeding following blunt abdominal trauma. Methods A prospective, multi-center study of consecutive adult patients...
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| Veröffentlicht in: | The American journal of emergency medicine 2017-06, Vol.35 (6), p.823-829 |
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| creator | Heidari, Kamran, MD Taghizadeh, Mehrdad, MD Mahmoudi, Sadrollah, MD Panahi, Hamidreza, MD Shad, Ensieh Ghaffari, MD Asadollahi, Shadi, MD |
| description | Abstract Purpose This study aimed to determine any association between positive findings in ultrasonography examination and initial BD value with regard to diagnosis of intra-abdominal bleeding following blunt abdominal trauma. Methods A prospective, multi-center study of consecutive adult patients was performed from April to September 2015. Demographics, initial vital signs and arterial BD were evaluated with respect to presence of any association with intra-abdominal bleeding and in-hospital mortality. FAST study was performed to find intra-abdominal bleeding. Receiver operating characteristic (ROC) curves tested the ability of BD to identify patients with intra-abdominal hemorrhage and probable mortality. Results A total of 879 patients were included in final analysis. The mean (SD) age was 36.68 (15.7) years and 714 patients (81.2%) were male. According to multivariable analysis, statistically significant association was observed between negative admission BD and both intra-abdominal bleeding (OR 3.48, 95% CI 2.06
–
5.88, p < 0.001) and in-hospital mortality (OR 1.55, 95% CI 1.49
–
1.63, p < 0.001). ROC curve analysis demonstrated sensitivity of 92.7% and specificity of 22.1% for the best cut-off value of BD (
− 8 mEq/L) to diagnose internal hemorrhage. Further, a cut-off value of
− 7 mEq/L demonstrated significant predictive performance, 94.8% sensitivity and 53.6% specificity for in-hospital mortality. Conclusion This study revealed that arterial BD is an early accessible important marker to identify intra-abdominal bleeding, as well as to predict overall in-hospital mortality in patients with blunt abdominal trauma. |
| doi_str_mv | 10.1016/j.ajem.2017.01.035 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1865519290</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0735675717300529</els_id><sourcerecordid>1865519290</sourcerecordid><originalsourceid>FETCH-LOGICAL-c439t-ccb728e295e60688adb0fbba67ad1b146ee16e8ef7db7a1a9e2b9df9b13d0b293</originalsourceid><addsrcrecordid>eNp9kk9v1DAQxS0EosvCF-CALHHhksXjbOwEIaRqRQtSJQ4tZ8t_JsghsRc7Keq3x9GWIvXAaS6_9zTz3hDyGtgOGIj3w04POO04A7ljsGN184RsoKl51YKEp2TDZN1UQjbyjLzIeWAMYN_sn5Mz3oIAzvmGDBfn1ze0j4macQkz1cbFyQc90jnpZdIf6CGmhKOefQzU4PwbMdBjzH72t0h7H5wPPzLVwVHtJp_zymnrXWV0RjqhzkvCCcP8kjzr9Zjx1f3cku8Xn28OX6qrb5dfD-dXld3X3VxZayRvkXcNCibaVjvDemO0kNqBgb1ABIEt9tIZqUF3yE3n-s5A7ZjhXb0l706-xxR_LZhnVdayOI46YFyyglY0DXS8YwV9-wgd4pLK9YXqgAshu5LhlvATZVPMOWGvjslPOt0pYGptQg1qbUKtTSgGqjRRRG_urRczoXuQ_I2-AB9PAJYsbj0mla3HYNH5hHZWLvr_-396JLejD97q8SfeYf53h8pcMXW9_sL6CiBrxpoS0x87F7AI</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1912667907</pqid></control><display><type>article</type><title>FAST for blunt abdominal trauma: Correlation between positive findings and admission acid-base measurement</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><source>ProQuest Central UK/Ireland</source><creator>Heidari, Kamran, MD ; Taghizadeh, Mehrdad, MD ; Mahmoudi, Sadrollah, MD ; Panahi, Hamidreza, MD ; Shad, Ensieh Ghaffari, MD ; Asadollahi, Shadi, MD</creator><creatorcontrib>Heidari, Kamran, MD ; Taghizadeh, Mehrdad, MD ; Mahmoudi, Sadrollah, MD ; Panahi, Hamidreza, MD ; Shad, Ensieh Ghaffari, MD ; Asadollahi, Shadi, MD</creatorcontrib><description>Abstract Purpose This study aimed to determine any association between positive findings in ultrasonography examination and initial BD value with regard to diagnosis of intra-abdominal bleeding following blunt abdominal trauma. Methods A prospective, multi-center study of consecutive adult patients was performed from April to September 2015. Demographics, initial vital signs and arterial BD were evaluated with respect to presence of any association with intra-abdominal bleeding and in-hospital mortality. FAST study was performed to find intra-abdominal bleeding. Receiver operating characteristic (ROC) curves tested the ability of BD to identify patients with intra-abdominal hemorrhage and probable mortality. Results A total of 879 patients were included in final analysis. The mean (SD) age was 36.68 (15.7) years and 714 patients (81.2%) were male. According to multivariable analysis, statistically significant association was observed between negative admission BD and both intra-abdominal bleeding (OR 3.48, 95% CI 2.06
–
5.88, p < 0.001) and in-hospital mortality (OR 1.55, 95% CI 1.49
–
1.63, p < 0.001). ROC curve analysis demonstrated sensitivity of 92.7% and specificity of 22.1% for the best cut-off value of BD (
− 8 mEq/L) to diagnose internal hemorrhage. Further, a cut-off value of
− 7 mEq/L demonstrated significant predictive performance, 94.8% sensitivity and 53.6% specificity for in-hospital mortality. Conclusion This study revealed that arterial BD is an early accessible important marker to identify intra-abdominal bleeding, as well as to predict overall in-hospital mortality in patients with blunt abdominal trauma.</description><identifier>ISSN: 0735-6757</identifier><identifier>EISSN: 1532-8171</identifier><identifier>DOI: 10.1016/j.ajem.2017.01.035</identifier><identifier>PMID: 28161222</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Abdomen ; Abdominal injuries ; Abdominal Injuries - diagnostic imaging ; Acid-Base Imbalance - diagnosis ; Acidosis ; Adult ; Bleeding ; Demographics ; Demography ; Emergency ; Emergency medical care ; Emergency services ; Female ; Hemoperitoneum ; Hemorrhage ; Hospital Mortality ; Hospitals ; Humans ; Iran ; Laboratories ; Logistic Models ; Male ; Metabolism ; Middle Aged ; Mortality ; Multivariate Analysis ; Patients ; Pediatrics ; Physicians ; Prospective Studies ; ROC Curve ; Sensitivity and Specificity ; Statistical analysis ; Tomography, X-Ray Computed ; Trauma ; Trauma Centers ; Ultrasonography ; Ultrasound ; Vital Signs ; Wounds, Nonpenetrating - diagnostic imaging ; Young Adult</subject><ispartof>The American journal of emergency medicine, 2017-06, Vol.35 (6), p.823-829</ispartof><rights>2017</rights><rights>Copyright © 2017. Published by Elsevier Inc.</rights><rights>Copyright Elsevier Limited 2017</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c439t-ccb728e295e60688adb0fbba67ad1b146ee16e8ef7db7a1a9e2b9df9b13d0b293</citedby><cites>FETCH-LOGICAL-c439t-ccb728e295e60688adb0fbba67ad1b146ee16e8ef7db7a1a9e2b9df9b13d0b293</cites><orcidid>0000-0002-0503-589X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1912667907?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28161222$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Heidari, Kamran, MD</creatorcontrib><creatorcontrib>Taghizadeh, Mehrdad, MD</creatorcontrib><creatorcontrib>Mahmoudi, Sadrollah, MD</creatorcontrib><creatorcontrib>Panahi, Hamidreza, MD</creatorcontrib><creatorcontrib>Shad, Ensieh Ghaffari, MD</creatorcontrib><creatorcontrib>Asadollahi, Shadi, MD</creatorcontrib><title>FAST for blunt abdominal trauma: Correlation between positive findings and admission acid-base measurement</title><title>The American journal of emergency medicine</title><addtitle>Am J Emerg Med</addtitle><description>Abstract Purpose This study aimed to determine any association between positive findings in ultrasonography examination and initial BD value with regard to diagnosis of intra-abdominal bleeding following blunt abdominal trauma. Methods A prospective, multi-center study of consecutive adult patients was performed from April to September 2015. Demographics, initial vital signs and arterial BD were evaluated with respect to presence of any association with intra-abdominal bleeding and in-hospital mortality. FAST study was performed to find intra-abdominal bleeding. Receiver operating characteristic (ROC) curves tested the ability of BD to identify patients with intra-abdominal hemorrhage and probable mortality. Results A total of 879 patients were included in final analysis. The mean (SD) age was 36.68 (15.7) years and 714 patients (81.2%) were male. According to multivariable analysis, statistically significant association was observed between negative admission BD and both intra-abdominal bleeding (OR 3.48, 95% CI 2.06
–
5.88, p < 0.001) and in-hospital mortality (OR 1.55, 95% CI 1.49
–
1.63, p < 0.001). ROC curve analysis demonstrated sensitivity of 92.7% and specificity of 22.1% for the best cut-off value of BD (
− 8 mEq/L) to diagnose internal hemorrhage. Further, a cut-off value of
− 7 mEq/L demonstrated significant predictive performance, 94.8% sensitivity and 53.6% specificity for in-hospital mortality. Conclusion This study revealed that arterial BD is an early accessible important marker to identify intra-abdominal bleeding, as well as to predict overall in-hospital mortality in patients with blunt abdominal trauma.</description><subject>Abdomen</subject><subject>Abdominal injuries</subject><subject>Abdominal Injuries - diagnostic imaging</subject><subject>Acid-Base Imbalance - diagnosis</subject><subject>Acidosis</subject><subject>Adult</subject><subject>Bleeding</subject><subject>Demographics</subject><subject>Demography</subject><subject>Emergency</subject><subject>Emergency medical care</subject><subject>Emergency services</subject><subject>Female</subject><subject>Hemoperitoneum</subject><subject>Hemorrhage</subject><subject>Hospital Mortality</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Iran</subject><subject>Laboratories</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Metabolism</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate Analysis</subject><subject>Patients</subject><subject>Pediatrics</subject><subject>Physicians</subject><subject>Prospective Studies</subject><subject>ROC Curve</subject><subject>Sensitivity and Specificity</subject><subject>Statistical analysis</subject><subject>Tomography, X-Ray Computed</subject><subject>Trauma</subject><subject>Trauma Centers</subject><subject>Ultrasonography</subject><subject>Ultrasound</subject><subject>Vital Signs</subject><subject>Wounds, Nonpenetrating - diagnostic imaging</subject><subject>Young Adult</subject><issn>0735-6757</issn><issn>1532-8171</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kk9v1DAQxS0EosvCF-CALHHhksXjbOwEIaRqRQtSJQ4tZ8t_JsghsRc7Keq3x9GWIvXAaS6_9zTz3hDyGtgOGIj3w04POO04A7ljsGN184RsoKl51YKEp2TDZN1UQjbyjLzIeWAMYN_sn5Mz3oIAzvmGDBfn1ze0j4macQkz1cbFyQc90jnpZdIf6CGmhKOefQzU4PwbMdBjzH72t0h7H5wPPzLVwVHtJp_zymnrXWV0RjqhzkvCCcP8kjzr9Zjx1f3cku8Xn28OX6qrb5dfD-dXld3X3VxZayRvkXcNCibaVjvDemO0kNqBgb1ABIEt9tIZqUF3yE3n-s5A7ZjhXb0l706-xxR_LZhnVdayOI46YFyyglY0DXS8YwV9-wgd4pLK9YXqgAshu5LhlvATZVPMOWGvjslPOt0pYGptQg1qbUKtTSgGqjRRRG_urRczoXuQ_I2-AB9PAJYsbj0mla3HYNH5hHZWLvr_-396JLejD97q8SfeYf53h8pcMXW9_sL6CiBrxpoS0x87F7AI</recordid><startdate>20170601</startdate><enddate>20170601</enddate><creator>Heidari, Kamran, MD</creator><creator>Taghizadeh, Mehrdad, MD</creator><creator>Mahmoudi, Sadrollah, MD</creator><creator>Panahi, Hamidreza, MD</creator><creator>Shad, Ensieh Ghaffari, MD</creator><creator>Asadollahi, Shadi, MD</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0503-589X</orcidid></search><sort><creationdate>20170601</creationdate><title>FAST for blunt abdominal trauma: Correlation between positive findings and admission acid-base measurement</title><author>Heidari, Kamran, MD ; Taghizadeh, Mehrdad, MD ; Mahmoudi, Sadrollah, MD ; Panahi, Hamidreza, MD ; Shad, Ensieh Ghaffari, MD ; Asadollahi, Shadi, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c439t-ccb728e295e60688adb0fbba67ad1b146ee16e8ef7db7a1a9e2b9df9b13d0b293</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Abdomen</topic><topic>Abdominal injuries</topic><topic>Abdominal Injuries - diagnostic imaging</topic><topic>Acid-Base Imbalance - diagnosis</topic><topic>Acidosis</topic><topic>Adult</topic><topic>Bleeding</topic><topic>Demographics</topic><topic>Demography</topic><topic>Emergency</topic><topic>Emergency medical care</topic><topic>Emergency services</topic><topic>Female</topic><topic>Hemoperitoneum</topic><topic>Hemorrhage</topic><topic>Hospital Mortality</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Iran</topic><topic>Laboratories</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Metabolism</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Multivariate Analysis</topic><topic>Patients</topic><topic>Pediatrics</topic><topic>Physicians</topic><topic>Prospective Studies</topic><topic>ROC Curve</topic><topic>Sensitivity and Specificity</topic><topic>Statistical analysis</topic><topic>Tomography, X-Ray Computed</topic><topic>Trauma</topic><topic>Trauma Centers</topic><topic>Ultrasonography</topic><topic>Ultrasound</topic><topic>Vital Signs</topic><topic>Wounds, Nonpenetrating - diagnostic imaging</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Heidari, Kamran, MD</creatorcontrib><creatorcontrib>Taghizadeh, Mehrdad, MD</creatorcontrib><creatorcontrib>Mahmoudi, Sadrollah, MD</creatorcontrib><creatorcontrib>Panahi, Hamidreza, MD</creatorcontrib><creatorcontrib>Shad, Ensieh Ghaffari, MD</creatorcontrib><creatorcontrib>Asadollahi, Shadi, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Heidari, Kamran, MD</au><au>Taghizadeh, Mehrdad, MD</au><au>Mahmoudi, Sadrollah, MD</au><au>Panahi, Hamidreza, MD</au><au>Shad, Ensieh Ghaffari, MD</au><au>Asadollahi, Shadi, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>FAST for blunt abdominal trauma: Correlation between positive findings and admission acid-base measurement</atitle><jtitle>The American journal of emergency medicine</jtitle><addtitle>Am J Emerg Med</addtitle><date>2017-06-01</date><risdate>2017</risdate><volume>35</volume><issue>6</issue><spage>823</spage><epage>829</epage><pages>823-829</pages><issn>0735-6757</issn><eissn>1532-8171</eissn><abstract>Abstract Purpose This study aimed to determine any association between positive findings in ultrasonography examination and initial BD value with regard to diagnosis of intra-abdominal bleeding following blunt abdominal trauma. Methods A prospective, multi-center study of consecutive adult patients was performed from April to September 2015. Demographics, initial vital signs and arterial BD were evaluated with respect to presence of any association with intra-abdominal bleeding and in-hospital mortality. FAST study was performed to find intra-abdominal bleeding. Receiver operating characteristic (ROC) curves tested the ability of BD to identify patients with intra-abdominal hemorrhage and probable mortality. Results A total of 879 patients were included in final analysis. The mean (SD) age was 36.68 (15.7) years and 714 patients (81.2%) were male. According to multivariable analysis, statistically significant association was observed between negative admission BD and both intra-abdominal bleeding (OR 3.48, 95% CI 2.06
–
5.88, p < 0.001) and in-hospital mortality (OR 1.55, 95% CI 1.49
–
1.63, p < 0.001). ROC curve analysis demonstrated sensitivity of 92.7% and specificity of 22.1% for the best cut-off value of BD (
− 8 mEq/L) to diagnose internal hemorrhage. Further, a cut-off value of
− 7 mEq/L demonstrated significant predictive performance, 94.8% sensitivity and 53.6% specificity for in-hospital mortality. Conclusion This study revealed that arterial BD is an early accessible important marker to identify intra-abdominal bleeding, as well as to predict overall in-hospital mortality in patients with blunt abdominal trauma.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28161222</pmid><doi>10.1016/j.ajem.2017.01.035</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0002-0503-589X</orcidid></addata></record> |
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| subjects | Abdomen Abdominal injuries Abdominal Injuries - diagnostic imaging Acid-Base Imbalance - diagnosis Acidosis Adult Bleeding Demographics Demography Emergency Emergency medical care Emergency services Female Hemoperitoneum Hemorrhage Hospital Mortality Hospitals Humans Iran Laboratories Logistic Models Male Metabolism Middle Aged Mortality Multivariate Analysis Patients Pediatrics Physicians Prospective Studies ROC Curve Sensitivity and Specificity Statistical analysis Tomography, X-Ray Computed Trauma Trauma Centers Ultrasonography Ultrasound Vital Signs Wounds, Nonpenetrating - diagnostic imaging Young Adult |
| title | FAST for blunt abdominal trauma: Correlation between positive findings and admission acid-base measurement |
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