en
Scientific article
English

Blunt abdominal trauma in children: a score to predict the absence of organ injury

Published inThe Journal of pediatrics, vol. 154, no. 6, p. 912-917
Publication date2009
Abstract

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 microg/L (1 point). A score of < or = 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 < or = 7, intra-abdominal lesions are very unlikely, and systematic CT scan or hospital admission may be avoided.

Keywords
  • Abdominal Injuries/diagnosis/ultrasonography
  • Biological Markers/analysis/blood
  • Child
  • Clinical Enzyme Tests
  • Female
  • Humans
  • Male
  • Predictive Value of Tests
  • Sensitivity and Specificity
  • Trauma Severity Indices
  • Ultrasonography, Doppler
  • Wounds, Nonpenetrating/diagnosis/ultrasonography
Citation (ISO format)
KARAM, Oliver Laurent et al. Blunt abdominal trauma in children: a score to predict the absence of organ injury. In: The Journal of pediatrics, 2009, vol. 154, n° 6, p. 912–917. doi: 10.1016/j.jpeds.2009.01.001
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Article (Published version)
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Identifiers
ISSN of the journal0022-3476
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