Document Type : Original Article
Authors
1
Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
2
Patient Safety Research Center, Clinical Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran
3
Department of Biostatistics, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran
4
Patient Safety Research Center, Clinical Research Institute, Mashhad University of Medical Sciences, Mashhad, Iran AND Department of Cardiovascular Diseases, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
Abstract
Background: Blunt abdominal trauma (BAT) is one of the major causes of mortality and morbidity, and its diagnosis and treatment are still challenging.
Objectives: This study aimed to evaluate the association between intra-abdominal injuries and clinical, imaging, and laboratory findings in children with BAT.
Methods: This cross-sectional study evaluated children diagnosed with BAT who were candidates for computed tomography (CT) of the abdomen and pelvis referred to the level-1 trauma center of Hashminejad, Taleghani, and Emdadi Hospitals of Mashhad. The demographic information, results of physical examination, CT, Sonography for Trauma (FAST), vital signs, and laboratory tests were recorded.
Results: A total of 96 children with BAT, with a median age of 10.5 (Q1, 8, Q3, 13), were enrolled. Organ injury was observed in 33% of patients on CT, 20% on FAST, and 54% on physical examination. Moreover, abnormal amylase, lipase, ALT, and AST were found in 23%, 12%, 31%, and 34% of cases, respectively. The abnormal levels of amylase and lipase showed 91.3% and 52% sensitivity, 97% and 100% specificity, and an AUC of 0.99 (95% CI 0.975-1.00) and 0.973 (95% CI 0.947-0.99), respectively. Moreover, abnormal AST and ALT levels had a sensitivity of 91.3% and 87.0%, specificity of 88% and 85.0%, and AUC of 0.95 (95% CI 0.88-1.00) and 0.928 (95% CI 0.84-1.00). The logistic regression results showed that the odds ratio for ALT>45 IU/L was 8.18 (95% CI 2.20, 30.31, P=0.002).
Conclusion: Serum ALT, AST, amylase, and lipase levels may be valuable in predicting BAT in children. However, further studies with more patients are necessary to confirm the results of the present study.
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