@article{ref1,
title="Proposal of a new preliminary scoring tool for early identification of significant blunt bowel and mesenteric injuries in patients at risk after road traffic crashes",
journal="European journal of trauma and emergency surgery",
year="2018",
author="Raharimanantsoa, Mahery and Zingg, Tobias and Thiery, Alicia and Brigand, Cécile and Delhorme, Jean-Baptiste and Romain, Benoît",
volume="44",
number="5",
pages="779-785",
abstract="PURPOSE: Blunt bowel and mesenteric injuries (BBMI) are regularly missed by abdominal computed tomography (CT) scans. The aim of this study was to develop a risk assessment tool for BBMI to help clinicians in decision-making for blunt trauma after road traffic crashes (RTCs). <br><br>METHODS: Single-center retrospective study of trauma patients from January 2010 to April 2015. All patients admitted to our hospital after blunt trauma following RTCs and CT scan at admission were assessed. <br><br>RESULTS: Of the 394 patients included, 78 (19.8%) required surgical exploration and 34 (43.6%) of these had a significant BBMI. A univariate and multivariate analysis were performed comparing patients with BBMI (n = 34) and patients without BBMI (n = 360). A score with a range from 0 to 13 was created. Scores from 8 to 9 were associated with 5-25% BBMI risk. The power of this new score ≥ 8 to predict a surgically significant BBMI had a sensitivity of 96%, specificity of 86.4%, positive predictive value (PPV) of 48% and negative predictive value (NPV) of 99.4%. <br><br>CONCLUSION: This score could be a valuable tool for the management of blunt trauma patients after RTA without a clear indication for laparotomy but at risk for BBMI. The outcome of this study suggests selective diagnostic laparoscopy for a score ≥ 8 in obtunded patients and ≥ 10 in all other. To assess the value and accuracy of this new score, a prospective validation of these retrospective findings is due.<p /> <p>Language: en</p>",
language="en",
issn="1863-9933",
doi="10.1007/s00068-017-0893-4",
url="http://dx.doi.org/10.1007/s00068-017-0893-4"
}