Hemoperitoneum score helps determine need for therapeutic laparotomy

Kimberley L. McKenney, Mark G. McKenney, Stephen M. Cohn, Raymond Compton, Diego B. Nunez, Matthew Dolich, Nicholas Namias

Research output: Contribution to journalArticle

67 Citations (Scopus)

Abstract

Purpose: Sonography provides a fast, portable, and noninvasive method for patient assessment. However, the benefit of providing real-time ultrasound (US) imaging and fluid quantification shortly after patient arrival has not been explored. The objective of this study was to prospectively validate a US hemoperitoneum scoring system developed at our institution and determine whether sonography can predict a therapeutic operation. Methods: For 12 months, prospective data on all patients undergoing a trauma sonogram were recorded. All sonograms positive for free fluid were given a hemoperitoneum score. The US score was compared with initial systolic blood pressure and base deficit to assess the ability of sonography to predict a therapeutic laparotomy. Results: Forty of 46 patients (87%) with a US score ≥ 3 required a therapeutic laparotomy. Forty-six of 54 patients with a US score < 3 (85%) did not need operative intervention. The sensitivity of sonography was 83% compared with 28% and 49% for systolic blood pressure and base deficit, respectively, in determining the need for therapeutic operation. Conclusion: We conclude that the majority of patients with a score ≥ 3 will need surgery. The US hemoperitoneum scoring system was a better predictor of a therapeutic laparotomy than initial blood pressure and/or base deficit.

Original languageEnglish
Pages (from-to)650-656
Number of pages7
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume50
Issue number4
StatePublished - May 3 2001

Fingerprint

Hemoperitoneum
Laparotomy
Ultrasonography
Blood Pressure
Therapeutics
Wounds and Injuries

Keywords

  • Hemoperitoneum
  • Laparotomy
  • Prospective
  • Score
  • Trauma
  • Ultrasound

ASJC Scopus subject areas

  • Surgery

Cite this

McKenney, K. L., McKenney, M. G., Cohn, S. M., Compton, R., Nunez, D. B., Dolich, M., & Namias, N. (2001). Hemoperitoneum score helps determine need for therapeutic laparotomy. Journal of Trauma - Injury, Infection and Critical Care, 50(4), 650-656.

Hemoperitoneum score helps determine need for therapeutic laparotomy. / McKenney, Kimberley L.; McKenney, Mark G.; Cohn, Stephen M.; Compton, Raymond; Nunez, Diego B.; Dolich, Matthew; Namias, Nicholas.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 50, No. 4, 03.05.2001, p. 650-656.

Research output: Contribution to journalArticle

McKenney, KL, McKenney, MG, Cohn, SM, Compton, R, Nunez, DB, Dolich, M & Namias, N 2001, 'Hemoperitoneum score helps determine need for therapeutic laparotomy', Journal of Trauma - Injury, Infection and Critical Care, vol. 50, no. 4, pp. 650-656.
McKenney KL, McKenney MG, Cohn SM, Compton R, Nunez DB, Dolich M et al. Hemoperitoneum score helps determine need for therapeutic laparotomy. Journal of Trauma - Injury, Infection and Critical Care. 2001 May 3;50(4):650-656.
McKenney, Kimberley L. ; McKenney, Mark G. ; Cohn, Stephen M. ; Compton, Raymond ; Nunez, Diego B. ; Dolich, Matthew ; Namias, Nicholas. / Hemoperitoneum score helps determine need for therapeutic laparotomy. In: Journal of Trauma - Injury, Infection and Critical Care. 2001 ; Vol. 50, No. 4. pp. 650-656.
@article{9ad097f1a9624c67a937a90afd2880bf,
title = "Hemoperitoneum score helps determine need for therapeutic laparotomy",
abstract = "Purpose: Sonography provides a fast, portable, and noninvasive method for patient assessment. However, the benefit of providing real-time ultrasound (US) imaging and fluid quantification shortly after patient arrival has not been explored. The objective of this study was to prospectively validate a US hemoperitoneum scoring system developed at our institution and determine whether sonography can predict a therapeutic operation. Methods: For 12 months, prospective data on all patients undergoing a trauma sonogram were recorded. All sonograms positive for free fluid were given a hemoperitoneum score. The US score was compared with initial systolic blood pressure and base deficit to assess the ability of sonography to predict a therapeutic laparotomy. Results: Forty of 46 patients (87{\%}) with a US score ≥ 3 required a therapeutic laparotomy. Forty-six of 54 patients with a US score < 3 (85{\%}) did not need operative intervention. The sensitivity of sonography was 83{\%} compared with 28{\%} and 49{\%} for systolic blood pressure and base deficit, respectively, in determining the need for therapeutic operation. Conclusion: We conclude that the majority of patients with a score ≥ 3 will need surgery. The US hemoperitoneum scoring system was a better predictor of a therapeutic laparotomy than initial blood pressure and/or base deficit.",
keywords = "Hemoperitoneum, Laparotomy, Prospective, Score, Trauma, Ultrasound",
author = "McKenney, {Kimberley L.} and McKenney, {Mark G.} and Cohn, {Stephen M.} and Raymond Compton and Nunez, {Diego B.} and Matthew Dolich and Nicholas Namias",
year = "2001",
month = "5",
day = "3",
language = "English",
volume = "50",
pages = "650--656",
journal = "Journal of Trauma and Acute Care Surgery",
issn = "2163-0755",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Hemoperitoneum score helps determine need for therapeutic laparotomy

AU - McKenney, Kimberley L.

AU - McKenney, Mark G.

AU - Cohn, Stephen M.

AU - Compton, Raymond

AU - Nunez, Diego B.

AU - Dolich, Matthew

AU - Namias, Nicholas

PY - 2001/5/3

Y1 - 2001/5/3

N2 - Purpose: Sonography provides a fast, portable, and noninvasive method for patient assessment. However, the benefit of providing real-time ultrasound (US) imaging and fluid quantification shortly after patient arrival has not been explored. The objective of this study was to prospectively validate a US hemoperitoneum scoring system developed at our institution and determine whether sonography can predict a therapeutic operation. Methods: For 12 months, prospective data on all patients undergoing a trauma sonogram were recorded. All sonograms positive for free fluid were given a hemoperitoneum score. The US score was compared with initial systolic blood pressure and base deficit to assess the ability of sonography to predict a therapeutic laparotomy. Results: Forty of 46 patients (87%) with a US score ≥ 3 required a therapeutic laparotomy. Forty-six of 54 patients with a US score < 3 (85%) did not need operative intervention. The sensitivity of sonography was 83% compared with 28% and 49% for systolic blood pressure and base deficit, respectively, in determining the need for therapeutic operation. Conclusion: We conclude that the majority of patients with a score ≥ 3 will need surgery. The US hemoperitoneum scoring system was a better predictor of a therapeutic laparotomy than initial blood pressure and/or base deficit.

AB - Purpose: Sonography provides a fast, portable, and noninvasive method for patient assessment. However, the benefit of providing real-time ultrasound (US) imaging and fluid quantification shortly after patient arrival has not been explored. The objective of this study was to prospectively validate a US hemoperitoneum scoring system developed at our institution and determine whether sonography can predict a therapeutic operation. Methods: For 12 months, prospective data on all patients undergoing a trauma sonogram were recorded. All sonograms positive for free fluid were given a hemoperitoneum score. The US score was compared with initial systolic blood pressure and base deficit to assess the ability of sonography to predict a therapeutic laparotomy. Results: Forty of 46 patients (87%) with a US score ≥ 3 required a therapeutic laparotomy. Forty-six of 54 patients with a US score < 3 (85%) did not need operative intervention. The sensitivity of sonography was 83% compared with 28% and 49% for systolic blood pressure and base deficit, respectively, in determining the need for therapeutic operation. Conclusion: We conclude that the majority of patients with a score ≥ 3 will need surgery. The US hemoperitoneum scoring system was a better predictor of a therapeutic laparotomy than initial blood pressure and/or base deficit.

KW - Hemoperitoneum

KW - Laparotomy

KW - Prospective

KW - Score

KW - Trauma

KW - Ultrasound

UR - http://www.scopus.com/inward/record.url?scp=0035063044&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035063044&partnerID=8YFLogxK

M3 - Article

C2 - 11303159

AN - SCOPUS:0035063044

VL - 50

SP - 650

EP - 656

JO - Journal of Trauma and Acute Care Surgery

JF - Journal of Trauma and Acute Care Surgery

SN - 2163-0755

IS - 4

ER -