Clinical Abdominal Scoring System in Predicting the Necessity of Laparotomy in Blunt Abdominal Trauma

ElArini, Ahmed Mahdi; Abdellatif, Tarek; Sallam, Ahmed M.; ebrahim, amr ahmed

doi:10.21608/zumj.2021.63767.2141

Cited by 3 publications

(2 citation statements)

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“…The assignment of a score to each characteristic collectively assists in evaluating the degree of trauma and the probability of requiring surgical intervention (8). In contrast, CASS mainly emphasizes assessing physical examination findings such as stomach discomfort, rebound tenderness, and seatbelt symptoms, assigning scores appropriately (9) (10). Research indicates that BATSS may provide more accuracy in terms of sensitivity and specificity when compared to CASS, even if both scoring systems have the same goal of predicting the need for surgical intervention.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Blunt Abdominal Trauma Severity Scoring (Batss) and Clinical Abdominal Scoring System (Cass) in Blunt Abdominal Trauma for Need of Surgical Intervention

SADIA,

KHALID,

ZULFIKAR

et al. 2024

Biol Clin Sci Res J

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Blunt abdominal trauma can result in severe intra-abdominal injuries that may necessitate surgery. Scoring systems such as Clinical Assessment Score for Suspected Abdominal Injury (CASS) and Blunt Abdominal Trauma in Severe Spleen Score (BATSS) aid in predicting the need for surgery but require further evaluation. Objective: To assess the efficacy of the CASS and BATSS scoring systems in predicting the necessity of surgical intervention for patients with blunt abdominal trauma. Methods: This comparative study was conducted at Dr. Ruth K. M. Pfau Civil Hospital Karachi from July 1, 2023, to December 31, 2023. Vital signs on admission, signs of abdominal tenderness, distension, guarding, and organ-specific symptoms were recorded for all participants. Diagnostic imaging findings from studies such as abdominal ultrasound, computed tomography (CT) scans, or X-rays were also collected. The study included a total of 185 participants. Statistical analysis included sensitivity and specificity calculations to compare the predictive accuracy of the CASS and BATSS scoring systems. Results: The mean age of the participants was 35.8±12.67 years, with 87% being males. Road traffic accidents were the most common mode of injury (89%). The BATSS scoring system demonstrated higher accuracy in predicting the necessity of surgical intervention after blunting abdominal trauma, with 65.9% sensitivity and 95% specificity compared to the CASS scoring system. Conclusion: The BATSS scoring system shows superior efficacy in predicting the need for surgical intervention following blunt abdominal trauma compared to the CASS scoring system. This suggests that the BATSS score may be a more reliable tool for clinicians in assessing the severity of abdominal injuries and determining the appropriate course of treatment.

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Section: Introductionmentioning

confidence: 99%

Comparison of Blunt Abdominal Trauma Severity Scoring (Batss) and Clinical Abdominal Scoring System (Cass) in Blunt Abdominal Trauma for Need of Surgical Intervention

SADIA,

KHALID,

ZULFIKAR

et al. 2024

Biol Clin Sci Res J

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“…(4) Another study that included 46 patients with only blunt abdominal trauma (BAT) at the Emergency Unit of the Department of General Surgery at Zagazig University Hospitals revealed that CASS has higher sensitivity and specificity in BAT patients than do imaging modalities such as USG of the abdomen and CT scan. (5) This score has a minimal measurement cost and a high degree of accuracy. With the aid of this score, patients who have suffered blunt abdominal injuries can cut down on the number of follow-up exams and consequently, on the expense of their care.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of clinical abdominal scoring system for predicting outcomes of blunt abdominal trauma

Yordanius,

Wiargitha,

Golden

et al. 2023

Univ Med

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Background Trauma has been called the neglected disease of modern society and the most common cause of death under 45 years. Determining the optimal prospective course of action may be aided by the adoption of a scoring system to evaluate urgent laparotomy intervention. A quick and easy technique to identify whether there are any intra-abdominal injuries is to use the clinical abdominal scoring system (CASS). The objective of this study was to evaluate CASS in predicting the outcomes in patients with blunt abdominal trauma (BAT). Methods A retrospective observational study was conducted involving 80 patients with suspected BAT that arrived at the emergency department. All patients with suspected BAT were scored using CASS and radiological investigations that were done in the ED. The decision to proceed with the surgery would be made if the patient had CASS >12 and/or if the radiological investigation showed features of BAT such as air under the diaphragm. Results Mean CASS score was 10.28 ± 1.340. The majority of the subjects (75 or 93.5%) had successful laparotomies, whereas only five (6.3%) had unsuccessful ones. Injuries to the spleen (42.6%), and liver (32%), combined injuries to the spleen and liver (2.6%), intestine (16%), pancreas (1.3%), bladder (4%), and kidneys (1.5%) were all found in positive laparotomies. The CASS has specificity of 60%, sensitivity of 80%, PPV 96.7%, and NPV 16.6%. Conclusions According to our data results, The CASS has a poor ability to predict the need for laparotomy in cases of blunt abdominal injuries as it shows low specificity.

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A Novelabdominal Scoring System for the Management of Patients With Blunt Traumaabdomen…. An Experience in Rural Based Tertiary Care Centre

Kumar¹,

K²

2021

ijsr

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Background: Trauma is one of the leading cause for morbidity and mortality. The most common is abdominal injury followed by extremities and head injury. Early diagnosis and timely intervention reduces the mortality by upto 50%. The common causes for blunt trauma abdomen(BTA) includes motor vehicle crashes, direct trauma and fall from heights Objectives: (a) To score all the patients with blunt trauma abdomen with Clinical Abdominal Scoring System (CASS). (b) To compare the score of clinical abdominal scoring system with USG/CTabdomen and pelvis ndings in patients of blunt trauma abdomen. Methods: Patients suspected to have blunt trauma abdomen were scored using CASS and radiological investigations were done in the ED. The decision to proceed with the surgery would be taken if the patient had CASS>12 and/or if the radiological investigation shows features of blunt trauma abdomen like air under diaphragm or grade IV/Vsolid organ injury. Results: Males were predominantly involved constituting around 81% and the rest being females with 19%. Most common age group involved in is 21-30years. Most common mode of injury was found to be RTA. Most common injured organs are spleen>liver>small intestine (ileum). The CASS have specicity of 84.62%, sensitivity of 99.2%, PPV-33.3%, NPV-100%. Total mortality in the study was 7.1% Conclusion: Most of the patients who had CASS <11 but hemodynamically stable can be managed conservatively. Patients with CASS of >12 are the potential candidates for the surgery. Thus use of CASS not only helps in timely intervention with better outcome but can be proved to be benecial for community health centre where a duty doctor can take immediate decision for referring the case without any undue delay.

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Clinical Abdominal Scoring System in Predicting the Necessity of Laparotomy in Blunt Abdominal Trauma

Cited by 3 publications

References 0 publications

Comparison of Blunt Abdominal Trauma Severity Scoring (Batss) and Clinical Abdominal Scoring System (Cass) in Blunt Abdominal Trauma for Need of Surgical Intervention

Comparison of Blunt Abdominal Trauma Severity Scoring (Batss) and Clinical Abdominal Scoring System (Cass) in Blunt Abdominal Trauma for Need of Surgical Intervention

Evaluation of clinical abdominal scoring system for predicting outcomes of blunt abdominal trauma

A Novelabdominal Scoring System for the Management of Patients With Blunt Traumaabdomen…. An Experience in Rural Based Tertiary Care Centre

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