Hemoperitoneum Score Helps Determine Need for Therapeutic Laparotomy
Document Type
Conference Proceeding
Publication Date
1-1-2001
Description
Purpose: Sonography provides a fast, portable, and noninvasive method for patient assessment. However, the benefit of providing real-time ultrasound (US) imaging and fluid quantification shortly after patient arrival has not been explored. The objective of this study was to prospectively validate a US hemoperitoneum scoring system developed at our institution and determine whether sonography can predict a therapeutic operation. Methods: For 12 months, prospective data on all patients undergoing a trauma sonogram were recorded. All sonograms positive for free fluid were given a hemoperitoneum score. The US score was compared with initial systolic blood pressure and base deficit to assess the ability of sonography to predict a therapeutic laparotomy. Results: Forty of 46 patients (87%) with a US score ≥ 3 required a therapeutic laparotomy. Forty-six of 54 patients with a US score < 3 (85%) did not need operative intervention. The sensitivity of sonography was 83% compared with 28% and 49% for systolic blood pressure and base deficit, respectively, in determining the need for therapeutic operation. Conclusion: We conclude that the majority of patients with a score ≥ 3 will need surgery. The US hemoperitoneum scoring system was a better predictor of a therapeutic laparotomy than initial blood pressure and/or base deficit.
Citation Information
McKenney, Kimberley L.; McKenney, Mark G.; Cohn, Stephen M.; Compton, Raymond; Nunez, Diego B.; Dolich, Matthew; and Namias, Nicholas. 2001. Hemoperitoneum Score Helps Determine Need for Therapeutic Laparotomy. Journal of Trauma - Injury, Infection and Critical Care. Vol.50(4). 650-656. https://doi.org/10.1097/00005373-200104000-00009 PMID: 11303159 ISSN: 1079-6061