title: Diagnostic Accuracy of Abdominal wall Ultrasonography and Local Wound Exploration in Predicting the Need for Laparotomy following Stab Wound.
abstract: BACKGROUND
  Screening of patients with anterior abdominal penetrating trauma in need for laparotomy is an important issue in management of these cases. This study aimed to compare the accuracy of abdominal wall ultrasonography (AWU) and local wound exploration (LWE) in this regard.
  
  
  METHODS
  This diagnostic accuracy study was conducted on ≥ 18 year-old patients presenting to emergency department with anterior abdominal stab wound and stable hemodynamics, to compare the characteristics of AWU and LWE in screening of patients in need of laparotomy.
  
  
  RESULTS
  50 cases with the mean age of 28.44 ± 7.14 years were included (80% male). Sensitivity, specificity and area under the receiver operating characteristic (ROC) curve of AWU were 70.58 (95% CI: 44.04 - 88.62), 93.33 (95% CI: 76.49 - 98.83), and 81.96 (95% CI: 69.91 - 94.01), respectively. These measures were 88.23 (62.25 - 97.93), 93.33 (76.49 - 98.83), and 90.78 (95% CI: 81.67 - 99.89) for LWE, respectively. The difference in overall accuracy of the two methods was not statistically significant (p = 0.0641).
  
  
  CONCLUSIONS
  Based on the findings of the present study, AWU and LWE had the same specificity but different sensitivities in screening of anterior abdominal stab wound patients in need of laparotomy. The overall accuracy of LWE was slightly higher (91.48% versus 85.1%).
authors.affiliation: Department of Emergency Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Vafaei
authors.affiliation: Department of Emergency Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Kamran
authors.initials: K
authors.lastname: Heidari
authors.affiliation: Department of Emergency Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Afshin
authors.initials: A
authors.lastname: Saboorizadeh
authors.affiliation: Department of Emergency Medicine, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Amin
authors.initials: A
authors.lastname: Shams Akhtari
keywords: Abdominal injuries; diagnostic techniques and procedures; penetrating; stab; ultrasonography; wounds