Clinical, sonological and radiographic predictors of abdominal injuries after blunt abdominal trauma

There are several situations that complicate the diagnosis of abdominal injuries. Physical examination may be unreliable due to the presence of multiple trauma or changes in the levels of consciousness. This prospective observational study was done consecutive adult blunt abdominal trauma patients. Parameters from pre hospital information, physical examination, laboratory investigations, FAST, and CR were recorded for all patients. Predictors for the presence of ≥1 injuries on abdominal CT were determined. 175 patients were included, with mean ages of 32.94± 14.21 years. 145 had injuries on abdominal CT. Patients with abdominal injuries had significantly lower mean systolic BP on admission (98.79±12.8 v/s 114±7.38), lower mean GCS (11.70±2.02 vs 13.10±1.74), significantly lower levels of hematocrit (29.18±8.31 v/s 34.33±6.46 %); significant difference in presence of abdominal bruises [pvalue ≤ 0.0001,or 6.669 CI (2.42-18.47)]; abdominal tenderness [p value ≤ 0.0001, or 63.708 CI (20.171-201.218)] and guarding /rigidity[ p value ≤ 0.0001, or 5.662 CI (2.054-15.608) ], significantly higher frequency of abnormal chest CR [p value 0.019, or: 7.886 CI (1.033-60.202)] ; significantly higher frequency of abnormal pelvic CR [p value : 0.011; or : 8.545 ( CI: 1.121-65.115)]; significantly higher frequency of FAST score of > 3 [ p value : ≤ 0.0001 , or 0.034 (0.005-0.256)] as compared to the group of patients with no organ injuries on CT. we observed that the predictors for injuries on CT are: Hemodynamic instability, Altered level of consciousness (GCS≤13), Decreased haematocrit levels, Abnormal physical examination of the abdomen (particularly abdominal tenderness), Fracture of the ribs ,Fracture of the pelvis and FAST score of >3.