Table of Contents Author Guidelines Submit a Manuscript
Emergency Medicine International
Volume 2014 (2014), Article ID 793437, 7 pages
http://dx.doi.org/10.1155/2014/793437
Research Article

Emergency Ultrasound Predicting the Need for Therapeutic Laparotomy among Blunt Abdominal Trauma Patients in a Sub-Saharan African Hospital

1Department of Surgery, College of Health Sciences, Makerere University, Kampala, Uganda
2Department of Radiology, College of Health Sciences, Makerere University, Kampala, Uganda
3Infectious Diseases Research Collaboration, Makerere University, Kampala, Uganda

Received 27 June 2013; Revised 19 December 2013; Accepted 3 January 2014; Published 13 February 2014

Academic Editor: Rade B. Vukmir

Copyright © 2014 P. C. M. Musiitwa et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. The trauma burden globally accounts for high levels of mortality and morbidity. Blunt abdominal trauma (BAT) contributes significantly to this burden. Patient’s evaluation for BAT remains a diagnostic challenge for emergency physicians. SSORTT gives a score that can predict the need for laparotomy. The objective of this study was to assess the accuracy of SSORTT score in predicting the need for a therapeutic laparotomy after BAT. Method. A prospective observational study. Eligible patients were evaluated for shock and the presence of haemoperitoneum using a portable ultrasound machine. Further evaluation of patients following the standard of care (SOC) protocol was done. The accuracy of SSORTT score in predicting therapeutic laparotomy was compared to SOC. Results. In total, 195 patients were evaluated; M : F ratio was 6 : 1. The commonest injuries were to the head 80 (42%) and the abdomen 54 (28%). A SSORTT score of >2 appropriately identified patients that needed a therapeutic laparotomy (with sensitivity 90%, specificity 90%, PPV 53%, and NPV 98%). The overall mortality rate was 17%. Conclusion. Patients with a SSORTT score of 2 and above had a high likelihood of requiring a therapeutic laparotomy. SSORTT scoring should be adopted for routine practice in low technology settings.