TY - JOUR
T1 - External validation of the Blunt Abdominal Trauma in Children (BATiC) score
T2 - Ruling out significant abdominal injury in children
AU - de Jong, Willem-Jan J.
AU - Stoepker, Leon
AU - Nellensteijn, David R.
AU - Groen, Henk
AU - El Moumni, Mostafa
AU - Hulscher, Jan B.
PY - 2014/5
Y1 - 2014/5
N2 - BACKGROUND: The aim of this study was to validate the use of the Blunt Abdominal Trauma in Children (BATiC) score. The BATiC score uses only readily available laboratory parameters, ultrasound results, and results from physical examination and does therefore not carry any risk of additional radiation exposure.METHODS: Data of pediatric trauma patients admitted to the shock room between 2006 and 2010 were retrospectively analyzed. Blunt abdominal trauma was defined radiologically or surgically. The BATiC score was computed using 10 parameters as follows: abnormal abdominal ultrasound finding, abdominal pain, peritoneal irritation, hemodynamic instability, aspartate aminotransferase greater than 60 U/L, alanine aminotransferase greater than 25 U/L, white blood cell count greater than 10 x 10(9)/L, lactate dehydrogenase greater than 330 U/L, amylase greater than 100 U/L, and creatinine greater than 110 mu mol/L. Sensitivity, specificity, negative predictive value, and positive predictive value were computed. Missing values were replaced using multiple imputation, and BATiC scores were calculated based on imputed values.RESULTS: Included were 216 patients, with 144 males, 72 females, and a median age of 12 years. Eighteen patients (8%) sustained abdominal injury. Median BATiC scores of patients with and without intra-abdominal injury were 9.2 (range, 6.6-15.4) and 2.2 (range, 0.0-10.6) respectively (p <0.001). When the BATiC score is used with a cutoff point of 6, the test showed a sensitivity of 100% and a specificity of 87%. Negative and positive predictive values were 100% and 41% respectively. The area under the curve was 0.98.CONCLUSION: The BATiC score can be a useful adjunct in the assessment of the presence of abdominal trauma in children and can help determine which patients might benefit from a computed tomographic scan and/or further treatment and which might not. (J Trauma Acute Care Surg. 2014; 76: 1282-1287. Copyright (C) 2014 by Lippincott Williams & Wilkins)
AB - BACKGROUND: The aim of this study was to validate the use of the Blunt Abdominal Trauma in Children (BATiC) score. The BATiC score uses only readily available laboratory parameters, ultrasound results, and results from physical examination and does therefore not carry any risk of additional radiation exposure.METHODS: Data of pediatric trauma patients admitted to the shock room between 2006 and 2010 were retrospectively analyzed. Blunt abdominal trauma was defined radiologically or surgically. The BATiC score was computed using 10 parameters as follows: abnormal abdominal ultrasound finding, abdominal pain, peritoneal irritation, hemodynamic instability, aspartate aminotransferase greater than 60 U/L, alanine aminotransferase greater than 25 U/L, white blood cell count greater than 10 x 10(9)/L, lactate dehydrogenase greater than 330 U/L, amylase greater than 100 U/L, and creatinine greater than 110 mu mol/L. Sensitivity, specificity, negative predictive value, and positive predictive value were computed. Missing values were replaced using multiple imputation, and BATiC scores were calculated based on imputed values.RESULTS: Included were 216 patients, with 144 males, 72 females, and a median age of 12 years. Eighteen patients (8%) sustained abdominal injury. Median BATiC scores of patients with and without intra-abdominal injury were 9.2 (range, 6.6-15.4) and 2.2 (range, 0.0-10.6) respectively (p <0.001). When the BATiC score is used with a cutoff point of 6, the test showed a sensitivity of 100% and a specificity of 87%. Negative and positive predictive values were 100% and 41% respectively. The area under the curve was 0.98.CONCLUSION: The BATiC score can be a useful adjunct in the assessment of the presence of abdominal trauma in children and can help determine which patients might benefit from a computed tomographic scan and/or further treatment and which might not. (J Trauma Acute Care Surg. 2014; 76: 1282-1287. Copyright (C) 2014 by Lippincott Williams & Wilkins)
KW - Blunt abdominal injury
KW - computed tomography
KW - radiation reduction in children
KW - clinical score
KW - trauma
KW - COMPUTED-TOMOGRAPHY
KW - INTRAABDOMINAL INJURY
KW - RADIATION-EXPOSURE
KW - RISK
KW - UTILITY
KW - SCANS
U2 - 10.1097/TA.0000000000000175
DO - 10.1097/TA.0000000000000175
M3 - Article
C2 - 24747461
SN - 2163-0755
VL - 76
SP - 1282
EP - 1287
JO - Journal of trauma and acute care surgery
JF - Journal of trauma and acute care surgery
IS - 5
ER -