Blunt Abdominal Trauma in Children: A Score to Predict the Absence of Organ Injury
Objectives To evaluate the initial workup and design a score that would allow ruling out significant intra-abdominal organ injuries following blunt abdominal traumas (BAT). Study design Data were collected prospectively from 147 consecutive patients admitted for BAT in a tertiary care hospital, over...
Gespeichert in:
Veröffentlicht in: | The Journal of pediatrics 2009-06, Vol.154 (6), p.912-917 |
---|---|
Hauptverfasser: | , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
Zusammenfassung: | Objectives To evaluate the initial workup and design a score that would allow ruling out significant intra-abdominal organ injuries following blunt abdominal traumas (BAT). Study design Data were collected prospectively from 147 consecutive patients admitted for BAT in a tertiary care hospital, over a 30-month period. Results Statistical significance of various parameters (trauma mechanism, clinical examination, laboratory tests, and ultrasound findings) were analyzed in relation to intra-abdominal injuries. The 10 parameters with the best negative predictive values (NPV) were then used to build a score (BATiC). The following points were attributed for these items: abnormal abdominal Doppler ultrasound (4 points), abdominal pain (2 points), peritoneal irritation (2 points), hemodynamic instability (2 points), aspartate aminotransferase >60 IU/L (2 points), alanine aminotransferase >25 IU/L (2 points), white blood cell count >9.5 g/L (1 point), LDH >330 IU/L (1 point), lipase >30 IU/L (1 point), and creatinine >50 μg/L (1 point). A score of ≤7 has a NPV of 97% and includes 67% of the studied population. Conclusions These results suggest that in hemodynamically stable patients with a normal abdominal Doppler ultrasound and a BATiC score of ≤7, intra-abdominal lesions are very unlikely, and systematic CT scan or hospital admission may be avoided. |
---|---|
ISSN: | 0022-3476 1097-6833 |
DOI: | 10.1016/j.jpeds.2009.01.001 |