Abstract
Introduction: Approximately one third of stable patients with significant intra-abdominal injury do not have significant intraperitoneal blood evident on admission. We hypothesized that a delayed, repeat ultrasound study (Secondary Ultrasound - SUS) will reveal additional intra-abdominal injuries and hemoperitoneum. Methods: We performed a prospective observational study of trauma patients at our Level I trauma center from April 2003 to December 2003. Patients underwent an initial ultrasound (US), followed by a SUS examination within 24 hours of admission. Patients not eligible for a SUS because of early discharge, operative intervention or death were excluded. All US and SUS exams were performed and evaluated by surgical/emergency medicine house staff or surgical attendings. Results: Five hundred forty-seven patients had both an initial US and a SUS examination. The sensitivity of the initial US in this patient population was 31.1% and increased to 72.1% on SUS (p < 0.001) for intra-abdominal injury or intra-abdominal fluid. The specificity for the initial US was 99.8% and 99.8% for SUS. The negative predictive value was 92.0% for the initial US and increased to 96.6% for SUS (p = 0.002). The accuracy of the initial ultrasound was 92.1% and increased to 96.7% on the SUS (p < 0.002). No patient with a negative SUS after 4 hours developed clinically significant hemoperitoneum. Conclusion: A secondary ultrasound of the abdomen significantly increases the sensitivity of ultrasound to detect intra-abdominal injury.
| Original language | English |
|---|---|
| Pages (from-to) | 934-938 |
| Number of pages | 5 |
| Journal | Journal of Trauma - Injury, Infection and Critical Care |
| Volume | 57 |
| Issue number | 5 |
| DOIs | |
| State | Published - Nov 1 2004 |
| Externally published | Yes |
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Keywords
- Ultrasound Blunt Abdominal Trauma Prospective study
ASJC Scopus subject areas
- Surgery
Cite this
Secondary ultrasound examination increases the sensitivity of the FAST exam in blunt trauma. / Blackbourne, Lorne H.; Soffer, Dror; McKenney, Mark; Amortegui, Jose; Schulman, Carl I; Crookes, Bruce; Habib, Fahim; Benjamin, Robert; Lopez, Peter P.; Namias, Nicholas; Lynn, Mauricio; Cohn, Stephen M.
In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 57, No. 5, 01.11.2004, p. 934-938.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Secondary ultrasound examination increases the sensitivity of the FAST exam in blunt trauma
AU - Blackbourne, Lorne H.
AU - Soffer, Dror
AU - McKenney, Mark
AU - Amortegui, Jose
AU - Schulman, Carl I
AU - Crookes, Bruce
AU - Habib, Fahim
AU - Benjamin, Robert
AU - Lopez, Peter P.
AU - Namias, Nicholas
AU - Lynn, Mauricio
AU - Cohn, Stephen M.
PY - 2004/11/1
Y1 - 2004/11/1
N2 - Introduction: Approximately one third of stable patients with significant intra-abdominal injury do not have significant intraperitoneal blood evident on admission. We hypothesized that a delayed, repeat ultrasound study (Secondary Ultrasound - SUS) will reveal additional intra-abdominal injuries and hemoperitoneum. Methods: We performed a prospective observational study of trauma patients at our Level I trauma center from April 2003 to December 2003. Patients underwent an initial ultrasound (US), followed by a SUS examination within 24 hours of admission. Patients not eligible for a SUS because of early discharge, operative intervention or death were excluded. All US and SUS exams were performed and evaluated by surgical/emergency medicine house staff or surgical attendings. Results: Five hundred forty-seven patients had both an initial US and a SUS examination. The sensitivity of the initial US in this patient population was 31.1% and increased to 72.1% on SUS (p < 0.001) for intra-abdominal injury or intra-abdominal fluid. The specificity for the initial US was 99.8% and 99.8% for SUS. The negative predictive value was 92.0% for the initial US and increased to 96.6% for SUS (p = 0.002). The accuracy of the initial ultrasound was 92.1% and increased to 96.7% on the SUS (p < 0.002). No patient with a negative SUS after 4 hours developed clinically significant hemoperitoneum. Conclusion: A secondary ultrasound of the abdomen significantly increases the sensitivity of ultrasound to detect intra-abdominal injury.
AB - Introduction: Approximately one third of stable patients with significant intra-abdominal injury do not have significant intraperitoneal blood evident on admission. We hypothesized that a delayed, repeat ultrasound study (Secondary Ultrasound - SUS) will reveal additional intra-abdominal injuries and hemoperitoneum. Methods: We performed a prospective observational study of trauma patients at our Level I trauma center from April 2003 to December 2003. Patients underwent an initial ultrasound (US), followed by a SUS examination within 24 hours of admission. Patients not eligible for a SUS because of early discharge, operative intervention or death were excluded. All US and SUS exams were performed and evaluated by surgical/emergency medicine house staff or surgical attendings. Results: Five hundred forty-seven patients had both an initial US and a SUS examination. The sensitivity of the initial US in this patient population was 31.1% and increased to 72.1% on SUS (p < 0.001) for intra-abdominal injury or intra-abdominal fluid. The specificity for the initial US was 99.8% and 99.8% for SUS. The negative predictive value was 92.0% for the initial US and increased to 96.6% for SUS (p = 0.002). The accuracy of the initial ultrasound was 92.1% and increased to 96.7% on the SUS (p < 0.002). No patient with a negative SUS after 4 hours developed clinically significant hemoperitoneum. Conclusion: A secondary ultrasound of the abdomen significantly increases the sensitivity of ultrasound to detect intra-abdominal injury.
KW - Ultrasound Blunt Abdominal Trauma Prospective study
UR - http://www.scopus.com/inward/record.url?scp=9644302315&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=9644302315&partnerID=8YFLogxK
U2 - 10.1097/01.TA.0000149494.40478.E4
DO - 10.1097/01.TA.0000149494.40478.E4
M3 - Article
C2 - 15580013
AN - SCOPUS:9644302315
VL - 57
SP - 934
EP - 938
JO - Journal of Trauma and Acute Care Surgery
JF - Journal of Trauma and Acute Care Surgery
SN - 2163-0755
IS - 5
ER -