A novel abdominal acoring systm for the management of patients with blunt trauma abdomen an experience in rural based tertiary care centre.

Abstract

Background: Trauma is one of the leading cause for morbidity and mortality. The most common is abdominal injury followed by extremities and head injury. Early diagnosis and timely intervention reduces the mortality by upto 50%. The common causes for blunt trauma abdomen(BTA) includes motor vehicle crashes, direct trauma and fall from heights Objectives: (a) To score all the patients with blunt trauma abdomen with Clinical Abdominal Scoring System (CASS). (b) To compare the score of clinical abdominal scoring system with USG/CT abdomen and pelvis ndings in patients of blunt trauma abdomen. Methods: Patients suspected to have blunt trauma abdomen were scored using CASS and radiological investigations were done in the ED. The decision to proceed with the surgery would be taken if the patient had CASS>12 and/or if the radiological investigation shows features of blunt trauma abdomen like air under diaphragm or grade IV/V solid organ injury. Results: Males were predominantly involved constituting around 81% and the rest being females with 19%. Most common age group involved in is 21-30years. Most common mode of injury was found to be RTA. Most common injured organs are spleen>liver>small intestine (ileum). The CASS have specicity of 84.62%, sensitivity of 99.2%, PPV-33.3%, NPV-100%. Total mortality in the study was 7.1% Conclusion: Most of the patients who had CASS <11 but hemodynamically stable can be managed conservatively. Patients with CASS of >12 are the potential candidates for the surgery. Thus use of CASS not only helps in timely intervention with better outcome but can be proved to be benecial for community health centre where a duty doctor can take immediate decision for referring the case without any undue delay.