How well does CT predict the need for laparotomy in hemodynamically stable patients with penetrating abdominal injury? A review and meta-analysis.
OBJECTIVE
The objective of our study was to determine how well CT predicts the need for laparotomy in hemodynamically stable patients with penetrating abdominal injury.


METHODS
We reviewed MEDLINE articles published from January 1994 through June 2008. The sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and accuracy were calculated for each source and collectively using a meta-analysis.


RESULTS
Of 180 relevant studies, five were included in the meta-analysis. Pooled weighted estimates of sensitivity, specificity, NPV, PPV, and accuracy were 94.90%, 95.38%, 98.62%, 84.51%, and 94.70%, respectively.


CONCLUSIONS
CT in patients with penetrating abdominal trauma has high sensitivity, specificity, NPV, and accuracy, but has lower PPV in determining the need for laparotomy. It follows that CT is an indispensable tool in predicting the need for laparotomy in these patients but still has room for improvement.
Goodman
Cyle S
CS
Chicago Medical School, 3333 Green Bay Rd., North Chicago, IL 60064, USA. cyle.goodman@my.rfums.org
Hur
Jee Y
JY
Adajar
Marc A
MA
Coulam
Curtis H
CH
D000007:Abdominal Injuries / Q000000981:diagnostic imaging* / Q000601:surgery*; D000328:Adult; D005260:Female; D006801:Humans; D007813:Laparotomy; D008297:Male; D011237:Predictive Value of Tests; D011859:Radiography; D012680:Sensitivity and Specificity; D014950:Wounds, Penetrating / Q000000981:diagnostic imaging* / Q000601:surgery*