Hemoperitoneum score helps determine need for therapeutic laparotomy

Kimberley L. McKenney, Mark G. McKenney, Stephen M. Cohn, Raymond Compton, Diego B. Nunez, Matthew Dolich, Nicholas Namias

Research output: Contribution to journalArticle

67 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)650-656
Number of pages7
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume50
Issue number4
DOIs
StatePublished - Jan 1 2001

Keywords

  • Hemoperitoneum
  • Laparotomy
  • Prospective
  • Score
  • Trauma
  • Ultrasound

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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  • Cite this

    McKenney, K. L., McKenney, M. G., Cohn, S. M., Compton, R., Nunez, D. B., Dolich, M., & Namias, N. (2001). Hemoperitoneum score helps determine need for therapeutic laparotomy. Journal of Trauma - Injury, Infection and Critical Care, 50(4), 650-656. https://doi.org/10.1097/00005373-200104000-00009