Developing a model for predicting intra-abdominal injuries following blunt trauma: a cross-sectional study

Saeed  Safari; Seyed Hadi  Aghili; Hamed  Maneshi; Shahram  Paydar; Zahra  Shayan; Mehri Farhang  Ranjbar

doi:10.18502/fem.v9i2.19192

Saeed Safari Research Center for Trauma in Police Operations, Directorate of Health, Rescue & Treatment, Police Headquarter, Tehran, Iran.
Seyed Hadi Aghili Research Center for Trauma in Police Operations, Directorate of Health, Rescue & Treatment, Police Headquarter, Tehran, Iran.
Hamed Maneshi Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
Shahram Paydar Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
Zahra Shayan Department of Biostatistics, School of Medicine, Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Mehri Farhang Ranjbar Research Center for Trauma in Police Operations, Directorate of Health, Rescue & Treatment, Police Headquarter, Tehran, Iran.

DOI: https://doi.org/10.18502/fem.v9i2.19192

Keywords: Abdominal Injuries; Blunt Injuries; Clinical Decision Rule; Injury Severity Score; Tomography, X-ray Computed

Abstract

Objective: Finding the associated factors of traumatic intra-abdominal injuries (IAIs) and designing a predictive model could minimize the unnecessary use of computed tomography (CT) scans. This study aimed to develop a risk stratification model in this regard.

Methods: This prospective cross-sectional study was conducted at the emergency department (ED) of a level III trauma center. In this study, we thoroughly examined the association between demographic details, physical examinations, laboratory tests, and ultrasonography with abdominopelvic CT scan results regarding the presence of intra-abdominal injuries following blunt abdominal trauma, trying to develop a risk stratification model in this regard.

Result: A total of 472 blunt trauma patients with a mean age of 39.06±18.49 (range: 15-96) were investigated (81.1% male). 47 intraabdominal damages in 45 (9.5%) patients were diagnosed. Based on logistic regression analysis, presence of abdominal pain (odds ratio [OR]: 39.60; 95% CI: 9.42,166.35), positive focused assessment sonography in trauma (FAST results (OR: 46.93; 95% CI: 14.79,148.89), and injury severity index (ISS)≥25 (OR: 6.43; 95% CI: 2.07,19.90) were significantly correlated with the presence of intraabdominal injuries in blunt trauma patients. The area under the ROC curve of the model was 0,865 (95% Cl: 0.805,0.926) with 86.67% sensitivity and 86.41% specificity.

Conclusion: Being accurate and user-friendly alongside broader criteria compared to similar studies makes our risk stratification model a reliable decision-making tool to optimize CT scan usage in the emergency department.