The diagnostic value of laboratory tests in detecting solid organ injuries in pediatric patients with blunt abdominal trauma

Computed tomography of the abdomen (CT) is used as the gold standard for detecting solid organ injuries (SOI) after blunt abdominal trauma (BAT). However, patient selection for CT is still controversial due to its potential risks. In this study, we aimed to investigate the usefulness of laboratory t...

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Bibliographic Details
Published in:The American journal of emergency medicine 2022-07, Vol.57, p.133-137
Main Authors: Kuas, Caglar, Acar, Nurdan, Ozakin, Engin, Karakilic, Evvah, Arda, Mehmet Surhan, Bastug, Betul Tiryaki, Yuksel, Gizem C., Canakci, Mustafa Emin
Format: Article
Language:English
Subjects:
Abdomen
Accuracy
Alanine
Alanine transaminase
Aspartate aminotransferase
Blood
Blunt abdominal trauma
Computed tomography
Consciousness
Consent
Emergency medical care
Emergency medical services
Hematocrit
Hemoglobin
Injuries
Laboratories
Laboratory studies
Laboratory tests
Lactic acid
Medical diagnosis
Observational studies
Patients
Pediatric trauma
Pediatrics
Solid organ injury
Statistical analysis
Trauma
Urinalysis
Vital signs
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Summary:Computed tomography of the abdomen (CT) is used as the gold standard for detecting solid organ injuries (SOI) after blunt abdominal trauma (BAT). However, patient selection for CT is still controversial due to its potential risks. In this study, we aimed to investigate the usefulness of laboratory tests in the detection or exclusion of SOI in pediatric patients evaluated in the emergency department due to BAT. The study was planned as a prospective, observational study and was conducted in the emergency department of a university hospital between February 2018 and February 2019. Patients under the age of 18 who were evaluated for BAT in the emergency department were included in the study. In the study, the diagnostic value of abnormal laboratory tests in detecting SOI was calculated by accepting CT results as the gold standard. Of the 323 patients included in the study, 118 (36%) were male. There were 283 patients who underwent CT. SOI was detected in 18 (6%) patients. Abnormal alanine aminotransferase, aspartate aminotransferase, amylase and lipase tests were found to be statistically significant in predicting SOI (p < 0.05). However, none of the tests were found to have sufficient sensitivity and specificity. Hemoglobin, hematocrit, lactate and base excess values were not found to be statistically significant in predicting SOI (p > 0.005). The hematologic laboratory tests are insufficient to rule out solid organ injury in pediatric patient with BAT.
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2022.04.039