Highlights
- •Prevalence of APCT within the adolescent blunt trauma population was found to be 59.3% (95% CI 54.2%-64.9%).
- •Of the patients who received APCT, 123 (37.9%) had positive findings on APCT with 65 (20.0%) having intraabdominal injury.
- •Of patients who received APCT 25 (7.7%) had injury that required abdominal surgery.
- •100% of patients with intraabdominal injury had at least one clinical predictor for intraabdominal injury while 28.7% of patients without intraabdominal injury who received APCT lacked any key predictors.
- •Abnormal abdominal exam, positive chest x-ray, positive or indeterminate FAST, elevated AST and elevated ALT were independently associated with intraabdominal injury.
Abstract
Introduction
The algorithm for evaluating adolescent patients with blunt trauma includes abdominal
pelvic CT (APCT). The aim of this study is to evaluate the utility of APCT in this
context.
Methods
We performed a retrospective review of adolescent (11 to 18 years of age) blunt trauma
patients at an urban adult level 1 trauma center from January 2015 to December 2019.
The primary outcome was the prevalence of positive findings on APCT scan. Additionally,
clinical risk factors concerning for intra-abdominal injury were analyzed.
Results
There were 546 patients evaluated for blunt trauma and the prevalence of APCT within
the population was 59.3% (95% CI 54.2%-64.9%). Of the patients who received APCT,
123 (37.9%) had positive findings on APCT. Only 25 patients (7.7% of those who underwent
APCT) required abdominal surgery while 40 patients (12.3%) had intraabdominal injury
that did not require surgery. Risk factors were present in 100% of patients with intraabdominal
injury and absent in 28.7% of patients without intraabdominal injury. Abnormal abdominal
exam, abnormal FAST, positive chest x-ray and elevated transaminases were independently
associated with intraabdominal injury.
Conclusions
Our study found that adolescent blunt trauma patients treated at our trauma center
had a higher rate of APCT usage, but a comparable rate of positive findings when compared
with the most recent literature. Future studies should focus on reducing the number
of patients who undergo APCT despite an absence of clinical risk factors.
Keywords
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Article info
Publication history
Published online: August 11, 2022
Accepted:
August 3,
2022
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
