FAST for blunt abdominal trauma: Correlation between positive findings and admission acid-base measurement.
OBJECTIVE
This study aimed to determine any association between positive findings in ultrasonography examination and initial BD value with regard to diagnosis of intra-abdominal bleeding following blunt abdominal trauma.


METHODS
A prospective, multi-center study of consecutive adult patients was performed from April to September 2015. Demographics, initial vital signs and arterial BD were evaluated with respect to presence of any association with intra-abdominal bleeding and in-hospital mortality. FAST study was performed to find intra-abdominal bleeding. Receiver operating characteristic (ROC) curves tested the ability of BD to identify patients with intra-abdominal hemorrhage and probable mortality.


RESULTS
A total of 879 patients were included in final analysis. The mean (SD) age was 36.68 (15.7) years and 714 patients (81.2%) were male. According to multivariable analysis, statistically significant association was observed between negative admission BD and both intra-abdominal bleeding (OR 3.48, 95% CI 2.06-5.88, p<0.001) and in-hospital mortality (OR 1.55, 95% CI 1.49-1.63, p<0.001). ROC curve analysis demonstrated sensitivity of 92.7% and specificity of 22.1% for the best cut-off value of BD (-8mEq/L) to diagnose internal hemorrhage. Further, a cut-off value of -7mEq/L demonstrated significant predictive performance, 94.8% sensitivity and 53.6% specificity for in-hospital mortality.


CONCLUSIONS
This study revealed that arterial BD is an early accessible important marker to identify intra-abdominal bleeding, as well as to predict overall in-hospital mortality in patients with blunt abdominal trauma.
Department of Emergency Medicine, Loghmane-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Kamran
K
Heidari
Department of Emergency Medicine, Loghmane-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Mehrdad
M
Taghizadeh
Baqiyatallah Hospital, Baqiyatallah University of Medical Sciences, Tehran, Iran.
Sadrollah
S
Mahmoudi
Department of Emergency Medicine, Loghmane-Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Hamidreza
H
Panahi
School of Medicine, Alborz University of Medical Sciences, Karaj, Tehran, Iran.
Ensieh
E
Ghaffari Shad
School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: shasadollahi@sbmu.ac.ir.
Shadi
S
Asadollahi
D000007:Abdominal Injuries / Q000000981:diagnostic imaging*; D000137:Acid-Base Imbalance / Q000175:diagnosis*; D000328:Adult; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007492:Iran; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014193:Trauma Centers; D014463:Ultrasonography; D055986:Vital Signs; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*; D055815:Young Adult
Abdominal injuries; Acidosis; Hemoperitoneum; Mortality; Ultrasonography