External validation of the Blunt Abdominal Trauma in Children (BATiC) score: Ruling out significant abdominal injury in children

Willem-Jan J. de Jong*, Leon Stoepker, David R. Nellensteijn, Henk Groen, Mostafa El Moumni, Jan B. Hulscher

*Corresponding author voor dit werk

OnderzoeksoutputAcademicpeer review

19 Citaten (Scopus)

Samenvatting

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)

Originele taal-2English
Pagina's (van-tot)1282-1287
Aantal pagina's6
TijdschriftJournal of trauma and acute care surgery
Volume76
Nummer van het tijdschrift5
DOI's
StatusPublished - mei-2014

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