The Predictive Value of Repeated Abdominal Ultrasonography in Patients with Multiple Trauma and Decreased Level of Consciousness: The Experience of a Resource-Limited Centre
Journal Title: Bulletin of Emergency And Trauma - Year 2018, Vol 6, Issue 1
Abstract
Objective: To determine the predictive value of repeated abdominal ultrasonography in patients with multiple trauma and decreased level of consciousness (LOC). Methods: This prospective cross-sectional study was conducted over a six-month period at Shahid Rajaee Trauma Hospital, Shiraz, Iran. We included hemodynamically stable blunt abdominal trauma patients with a decreased LOC (Glasgow Coma Scale ≤ 13) who were referred to the neurosurgery ICU ward. Included cases underwent 1 contrast-enhanced CT scan and two-time ultrasonographic study of the abdomen with an interval of 48 hours. The diagnostic accuracy of the ultrasonography was determined according to the CT-scan results. Results: Overall 80 patients with mean age of 37.75 ± 18.67 years were included. There were 17 (21.3%) women and 63 (78.8%) men among the patients. Compared with the CT-Scan, the first ultrasonography showed a sensitivity of 60%, specificity of 80%, PPV of 16.60%, NPV of 96.80%, and a diagnostic accuracy of 70%. The same values for the second ultrasonographic study were 80%, 79%, 20%, 98%, and 79%, respectively. In 4 (5%) patients whose first ultrasonography and CT scan results were negative, the second ultrasonography was positive for injury. Conclusion: In patients with blunt trauma to the abdomen, when the only indication of abdominal CT scan is a decreased LOC, two ultrasonographic studies can replace a CT imaging.
Authors and Affiliations
Shahram Paydar, Behnam Dalfardi, Bardia Zangbar-Sabegh, Hossein Heidaripour, Leila Pourandi, Alireza Shakibafard, Mehdi Tahmtan, Mohammad Hadi Niakan
Handlebar Hernia with Triple Herniation and Perforation: A Case Report and Literature Review
Blunt trauma abdomen is a very common entity but traumatic abdominal wall hernia is not that common. Herniation through abdominal wall usually occurs following trauma with seat belt, motor cycle, bicycle handle bar etc....
Massive Blood Transfusions and Outcomes in Trauma Patients; An Intention to Treat Analysis
Objective: To determine if there exists an upper limit for amount of blood transfused in trauma patients before it reaches a point of futility. Methods: A prospective cohort study was conducted on 131 patients who receiv...
Inferior Vena Cava Repair Using Serosal Patch of Small Bowel: An Experimental Study
Objective: To evaluate the feasibility and results of using serosal patch of small bowel for repair and replacement of inferior vena cava (IVC) after resection of a part of infra-renal IVC in an animal model, as it may b...
Epidemiology of Road Traffic Injuries among Elderly People; A Systematic Review and Meta-Analysis
Objective: To systematically review the epidemiological patterns and interventions for prevention of road traffic injuries (RTIs) among elderly. Methods: Searching keywords including: accident, trauma, road injury, road...
Correlation between Success Rates of Cardiopulmonary Cerebral Resuscitation and the Educational Level of the Team Leader; A Cross-Sectional Study
Objectives: To determine the correlation between the success rates of the cardiopulmonary cerebral resuscitation (CPCR) and the team’s leader education and skill level in Shiraz, southern Iran. Method: This cross-section...