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Incidence of intra-abdominal injuries in hemodynamically stable blunt trauma patients with a normal computed tomography scan admitted to the emergency department.
Zarama, Virginia; Torres, Nicolás; Duque, Esteban; Arango-Ibañez, Juan Pablo; Duran, Karina; Azcárate, Valeria; Maya, Duban A; Sánchez, Álvaro I.
Afiliación
  • Zarama V; Facultad de Ciencias de la Salud, Universidad Icesi, Carrera 98 # 18-49, Cali, 760032, Colombia. vzarama@icesi.edu.co.
  • Torres N; Department of Emergency Medicine, Fundación Valle del Lili, Cali, Colombia. vzarama@icesi.edu.co.
  • Duque E; Department of Surgery, Fundación Valle del Lili, Cali, Colombia.
  • Arango-Ibañez JP; Facultad de Ciencias de la Salud, Universidad Icesi, Carrera 98 # 18-49, Cali, 760032, Colombia.
  • Duran K; Centro de Investigaciones Clínicas (CIC), Fundación Valle del Lili, Cali, Colombia.
  • Azcárate V; Facultad de Ciencias de la Salud, Universidad Icesi, Carrera 98 # 18-49, Cali, 760032, Colombia.
  • Maya DA; Facultad de Ciencias de la Salud, Universidad Icesi, Carrera 98 # 18-49, Cali, 760032, Colombia.
  • Sánchez ÁI; Department of Emergency Medicine, Fundación Valle del Lili, Cali, Colombia.
BMC Emerg Med ; 24(1): 103, 2024 Jun 21.
Article en En | MEDLINE | ID: mdl-38902603
ABSTRACT

OBJECTIVES:

Blunt abdominal trauma is a common cause of emergency department admission. Computed tomography (CT) scanning is the gold standard method for identifying intra-abdominal injuries in patients experiencing blunt trauma, especially those with high-energy trauma. Although the diagnostic accuracy of this imaging technique is very high, patient admission and prolonged observation protocols are still common practices worldwide. We aimed to evaluate the incidence of intra-abdominal injury in hemodynamically stable patients with high-energy blunt trauma and a normal abdominal CT scan at a Level-1 Trauma Center in Colombia, South America, to assess the relevance of a prolonged observation period.

METHODS:

We performed a retrospective study of patients admitted to the emergency department for blunt trauma between 2021 and 2022. All consecutive patients with high-energy mechanisms of trauma and a normal CT scan at admission were included. Our primary outcomes were the incidence of intra-abdominal injury identified during a 24-hour observation period or hospital stay, ICU admission, and death.

RESULTS:

We included 480 patients who met the inclusion criteria. The median age was 33 (IQR 25.5, 47), and 74.2% were male. The most common mechanisms of injury were motor vehicle accidents (64.2%), falls from height (26%), and falls from bikes (3.1%). A total of 99.2% of patients had a Revised Trauma Score of 8. Only 1 patient (0.2%) (95% CI 0.01-1.16) presented with an abdominal injury during the observation period. No ICU admissions or deaths were reported.

CONCLUSION:

The incidence of intra-abdominal injury in patients with hemodynamically stable blunt trauma and a negative abdominal CT scan is extremely low, and prolonged observation may not be justified in these patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Heridas no Penetrantes / Tomografía Computarizada por Rayos X / Servicio de Urgencia en Hospital / Traumatismos Abdominales Límite: Adult / Female / Humans / Male / Middle aged País/Región como asunto: America do sul / Colombia Idioma: En Revista: BMC Emerg Med Asunto de la revista: MEDICINA DE EMERGENCIA Año: 2024 Tipo del documento: Article País de afiliación: Colombia Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Heridas no Penetrantes / Tomografía Computarizada por Rayos X / Servicio de Urgencia en Hospital / Traumatismos Abdominales Límite: Adult / Female / Humans / Male / Middle aged País/Región como asunto: America do sul / Colombia Idioma: En Revista: BMC Emerg Med Asunto de la revista: MEDICINA DE EMERGENCIA Año: 2024 Tipo del documento: Article País de afiliación: Colombia Pais de publicación: Reino Unido