Abstract

Purpose: This study aimed to determine any association between positive findings in ultrasonography examination and initial BD valuewith regard to diagnosis of intra-abdominal bleeding following blunt abdominal trauma. Methods: A prospective, multi-center study of consecutive adult patients was performed from April to September 2015. Demographics, initial vital signs and arterial BDwere evaluated with respect to presence of any association with intra-abdominal bleeding and in-hospital mortality. FAST study was performed to find intra-abdominal bleeding. Receiver operating characteristic (ROC) curves tested the ability of BD to identify patients with intraabdominal hemorrhage and probable mortality. Results: A total of 879 patientswere included in final analysis. The mean (SD) agewas 36.68 (15.7) years and 714 patients (81.2) were male. According tomultivariable analysis, statistically significant associationwas observed between negative admission BD and both intra-abdominal bleeding (OR 3.48, 95 CI 2.06-5.88, p < 0.001) and inhospital mortality (OR 1.55, 95 CI 1.49-1.63, p < 0.001). ROC curve analysis demonstrated sensitivity of 92.7 and specificity of 22.1 for the best cut-off value of BD (-8 mEq/L) to diagnose internal hemorrhage. Further, a cut-off value of-7 mEq/L demonstrated significant predictive performance, 94.8 sensitivity and 53.6 specificity for in-hospital mortality. Conclusion: This study revealed that arterial BD is an early accessible important marker to identify intra-abdominal bleeding, as well as to predict overall in-hospital mortality in patients with blunt abdominal trauma. (C) 2017 Published by Elsevier Inc.