Email this article Non-operative management of blunt abdominal trauma: positive predictors
- Authors: Pankratov A.A.1,2, Izrailov R.E.1, Chudnykh S.M.1, Khat'kov I.E.1
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Affiliations:
- A.I. Yevdokimov Moscow State University of Medicine and Dentistry
- City Clinical Hospital No. 68 of Moscow City Health Department
- Issue: Vol 45, No 5 (2017)
- Pages: 416-422
- Section: ARTICLES
- URL: https://almclinmed.ru/jour/article/view/618
- DOI: https://doi.org/10.18786/2072-0505-2017-45-5-416-422
- ID: 618
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Abstract
Background: Over the last years a non-operative management (NOM) of blunt abdominal trauma has been included into the standard treatment guidelines in leading trauma centers all over the world. The success of NOM is based on careful patient selection. Nevertheless, the selection criteria have not been clearly determined up to now.
Aim: To identify predictors of successful NOM and to create a diagnostic and treatment algorithm for its implementation.
Materials and methods: 209 patients with abdominal trauma who underwent laparoscopy or NOM from January 2006 to September 2015 were included in the study. The hemoperitoneum volume and organ injury rate evaluated by using ultrasonography and computed tomography scan, as well as hemoglobin level, blood pressure, and peripheral pulse were analyzed. We performed comparative analysis of prognostic values of various selection criteria for NOM, such as: 1) Huang and McKenney ultrasound scoring systems for hemoperitoneum quantification; 2) hemodynamic parameters; 3) hemoglobin levels; 4) various combinations of the above mentioned factors; 5) Sonographic Scoring for Operating Room Triage in Trauma (SSORTT) scoring system.
Results: Positive prognostic values of parameters included into the study varied from 88 to 91.7% when used separately or in combination with other scored factors. Furthermore, there was no significant difference between positive predictive value of all combinations of factors and McKenney ultrasound hemoperitoneum scoring system used alone.
Conclusion: The proposed predictors as well as diagnostic and treatment algorithm are easy-to-use and available in clinical practice.
Keywords
About the authors
A. A. Pankratov
A.I. Yevdokimov Moscow State University of Medicine and Dentistry; City Clinical Hospital No. 68 of Moscow City Health Department
Author for correspondence.
Email: aapankratov@mail.ru
Pankratov Aleksey A. – MD, PhD, Assistant Lecturer, Chair of Faculty Surgery No. 2 MSUMD, Surgeon CCH No. 68.
20–1 Delegatskaya ul., Moscow, 127473, +7 (926) 130 25 68
РоссияR. E. Izrailov
A.I. Yevdokimov Moscow State University of Medicine and Dentistry
Email: fake@neicon.ru
Izrailov Roman E. – MD, PhD, Professor, Chair of Faculty Surgery No. 2.
20–1 Delegatskaya ul., Moscow, 127473
РоссияS. M. Chudnykh
A.I. Yevdokimov Moscow State University of Medicine and Dentistry
Email: fake@neicon.ru
Chudnykh Sergey M. – MD, PhD, Professor, Chair of Faculty Surgery No. 2.
20–1 Delegatskaya ul., Moscow, 127473
РоссияI. E. Khat'kov
A.I. Yevdokimov Moscow State University of Medicine and Dentistry
Email: fake@neicon.ru
Khat'kov Igor' E. – MD, PhD, Professor, Member-Correspondent of Russian Academy of Sciences, Head of Chair of Faculty Surgery No. 2.
20–1 Delegatskaya ul., Moscow, 127473
РоссияReferences
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