Diagnosis of intraabdominal injury after blunt abdominal trauma by combination of ultrasound, urine analysis and shock index

Abstract

Background and purpose: The purpose of this study was to compare ultrasound and urine analysis and shock index with CT scan in the diagnosis of intraabdominal injury (IAI) in blunt abdominal trauma (BAT). Material and Methods: During 2011/3/21 to 2012/3/20, all adult patients with BAT presenting to the Emergency Department of Imam Hossain Hospital were studied. The sensitivity, specificity, positive (PPV), negative predictive values (NPV), LR + (positive likelihood ratio) and LR- (negative likelihood ratio) of ultrasound and hematuria and shock index were compared with abdominopelvic CT scan. Results: Motor vehicle accident was the most common cause of trauma. Sensitivity, specificity, PPV, NPV, LR + and LR- of three factors (ultrasound, hematuria and shock index above 0.8) in comparison with abdominal CT in the diagnosis of abdominal organ injury were 91.7%, 76.2%, 46.3%, 97.6%, 3.84 and, 0.11, respectively. But sensitivity, specificity, positive and negative predictive value, LR + and LR- of ultrasound alone were 81.3%, 94.9%, 78.0%, 95.8%, 15.8 and 0.2, respectively. Conclusion: The findings of this study suggest that although the use of ultrasound and urinalysis for hematuria and shock index compared with abdominal CT scan in the diagnosis of traumatic IAI has high sensitivity and NPV, but adding shock index and urinalysis to the ultrasound has no statistically significant improvement in the diagnosis of IAI, and cannot be replaced by CT scanning.