Developing a model for predicting intra-abdominal injuries following blunt trauma; a cross-sectional study

Abstract

Objective: Finding the associated factors of traumatic intra-abdominal injuries (IAIs) and designing a predictive model could minimize the unnecessary use of computed tomography (CT) scans. This study aimed to develop a risk stratification model in this regard. Methods: This prospective cross-sectional study was conducted at the emergency department (ED) of a level III trauma center. In this study, we thoroughly examined the association between demographic details, physical examinations, laboratory tests, and ultrasonography with abdominopelvic CT scan results regarding the presence of intra-abdominal injuries following blunt abdominal trauma, trying to develop a risk stratification model in this regard. Result: A total of 472 blunt trauma patients with a mean age of 39.06±18.49 (range: 15-96) were investigated (81.1% male). 47 intraabdominal damages in 45 (9.5%) patients were diagnosed. Based on logistic regression analysis, presence of abdominal pain (odds ratio [OR]: 39.60; 95% CI: 9.42,166.35), positive focused assessment sonography in trauma (FAST results (OR: 46.93; 95% CI: 14079,148.89), and injury severity index (ISS)≥25 (OR: 6.43; 95% CI: 2.07,19.90) were significantly correlated with the presence of intraabdominal injuries in blunt trauma patients. The area under the ROC curve of the model was 0,865 (95% Cl: 0.805,0.926) with 86.67% sensitivity and 86.41% specificity. Conclusion: Being accurate and user-friendly alongside broader criteria compared to similar studies makes our risk stratification model a reliable decision-making tool to optimize CT scan usage in the emergency department.

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Keywords
Abdominal Injuries Blunt Injuries Clinical Decision Rule Injury Severity Score Tomography X-ray Computed
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Safari S, Aghili SH, Maneshi H, Paydar S, Shayan Z, Farhang Ranjbar M. Developing a model for predicting intra-abdominal injuries following blunt trauma; a cross-sectional study. Front Emerg Med. 2025;.

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