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Author Holmes, James F. ♦ McGahan, John P. ♦ Wisner, David H.
Source World Health Organization (WHO)-Global Index Medicus
Content type Text
Publisher Elsevier
File Format HTM / HTML
Language English
Difficulty Level Medium
Subject Domain (in DDC) Social sciences ♦ Social problems & services; associations ♦ Social welfare problems & services ♦ Natural sciences & mathematics ♦ Life sciences; biology ♦ Natural history of organisms ♦ Technology ♦ Medicine & health ♦ Pharmacology and therapeutics ♦ Diseases ♦ Manufacture for specific uses ♦ Precision instruments & other devices
Subject Domain (in MeSH) Eukaryota ♦ Organisms ♦ Wounds and Injuries ♦ Diseases ♦ Diagnosis ♦ Therapeutics ♦ Investigative Techniques ♦ Analytical, Diagnostic and Therapeutic Techniques and Equipment ♦ Persons ♦ Persons ♦ Health Care Facilities, Manpower, and Services ♦ Health Care
Subject Keyword Discipline Emergency ♦ Discipline Medicine ♦ Abdominal Injuries ♦ Tomography, X-ray Computed ♦ Wounds, Nonpenetrating ♦ Adult ♦ Female ♦ Humans ♦ Male ♦ Middle Aged ♦ Patient Admission ♦ Statistics & Numerical Data ♦ Prospective Studies ♦ Risk Factors ♦ Trauma Centers ♦ Young Adult ♦ Journal Article
Abstract OBJECTIVE: The objective of this study is to determine the rate of intra-abdominal injury (IAI) in adults with blunt abdominal trauma after a normal abdominal computed tomographic (CT) scan. We hypothesize that the risk of subsequent IAI is so low that hospital admission and observation for possible IAI are unnecessary. METHODS: We conducted a prospective, observational cohort study of adults (>18 years) with blunt trauma who underwent abdominal CT scanning in the emergency department. Computed tomographic scans were obtained with intravenous contrast but no oral contrast. Abnormalities on abdominal CT included all visualized IAIs or any finding suggestive of possible IAI. Patients were followed up to determine the presence or absence of IAI and the need for therapeutic intervention if IAI was identified. RESULTS: Of the 3103 patients undergoing abdominal CT, 2734 (88%) had normal CT scans. The median age was 39 years (interquartile range, 26-51 years); and 2141 (78%) were admitted to the hospital. Eight (0.3%; 95% confidence interval, 0.1%-0.6%) were identified with IAIs after normal abdominal CT scans including the following injuries: pancreas (5), liver (4), gastrointestinal (2), and spleen (2). Five underwent therapy at laparotomy. Abdominal CT had a likelihood ratio (+) of 20.9 (95% confidence interval, 17.7-24.8) and likelihood ratio (-) of 0.034 (0.017-0.068). CONCLUSION: Adult patients with blunt torso trauma and normal abdominal CT scans are at low risk for subsequently identified IAI. Thus, hospitalization for evaluation of possible IAI after a normal abdominal CT scan is unnecessary in most cases.
Description Country affiliation: United States
Author Affiliation: Holmes JF ( Department of Emergency Medicine, UC Davis School of Medicine, Sacramento, CA, USA. jfholmes@ucdavis.edu)
ISSN 07356757
Educational Role Student ♦ Teacher
Age Range above 22 year
Educational Use Reading ♦ Research ♦ Self Learning
Interactivity Type Expositive
Education Level UG and PG
Learning Resource Type Article
Publisher Date 2012-05-01
Publisher Place United States
e-ISSN 15328171
Journal The American Journal of Emergency Medicine
Volume Number 30
Issue Number 4


Source: WHO-Global Index Medicus