Screening ultrasonography of 2,204 patients with blunt abdominal trauma in the Wenchuan earthquake

Zhou, Jixiang; Huang, Jingcao; Wu, Hong; Jiang, Hui; Zhang, Heqing; Prasoon, Pankaj; Xu, Yan; Bai, Yan; Qiu, Junyi; Zeng, Yong

doi:10.1097/ta.0b013e318256dfe1

Cited by 19 publications

(8 citation statements)

References 16 publications

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“…Zhou et al reviewed earthquake-related injuries at 701 hospitals during the Wenchuan earthquake. 25 Ultrasounds were reviewed by both an experienced surgeon and resident sonographer and compared against all subsequent imaging modalities, surgical findings, autopsy reports, and/or clinical course. All ultrasounds were performed within 24 hours to evaluate patients with suspected blunt abdominal trauma and were performed in the hospital.…”

Section: Discussionmentioning

confidence: 99%

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Accuracy of Focused Assessment with Sonography for Trauma (FAST) in Disaster Settings: A Meta-Analysis and Systematic Review

Lee

Balk

Schafer

et al. 2019

Disaster med. public health prep.

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Focused assessment with sonography for trauma (FAST) has been incorporated into the initial evaluation of trauma for decades. It is an important screening tool in the detection of intra-abdominal fluid. The objective of this study was to perform a systematic review of the use and accuracy of FAST as an imaging tool for blunt abdominal trauma in disaster/mass casualty settings. A systematic review of literature was conducted using key words and search terms. Two independent reviewers screened abstracts to determine inclusion using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS). For studies passing QUADAS, a meta-analysis was performed calculating sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). FAST results were compared with the gold standard, which was a combination of CT scan results, operative findings, and medical records of the clinical course. Initial database screening resulted in 133 articles, of which 21 were selected for QUADAS evaluation. Five studies passed QUADAS and were selected in the final meta-analysis, with a total of 4263 patients. The sensitivity of FAST was 92.1% (87.8–95.6), specificity 98.7% (96.0–99.9), PPV 90.7% (70.0–98.0), and NPV 98.8% (98.1–99.5) for the detection of intra-abdominal injury. In our meta-analysis, FAST was both sensitive and specific in the evaluation of trauma in the disaster setting.

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Section: Discussionmentioning

confidence: 99%

“…Another potential weakness of this study is that 2 of the included studies involve the same earthquake, the Wenchuan earthquake. Zhou et al 25 retrospectively reviewed medical records from 701 hospitals, making it possible that some of the data included in his study were included in Dan et. al's 24 study.…”

Section: Limitationsmentioning

confidence: 99%

Accuracy of Focused Assessment with Sonography for Trauma (FAST) in Disaster Settings: A Meta-Analysis and Systematic Review

Lee

Balk

Schafer

et al. 2019

Disaster med. public health prep.

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“…US or CEUS is used as an alternative to CT for follow-up of fluid collections, pseudocysts, and pancreatic disruptions after pancreatic trauma mainly in children or in low-resource settings [16, 26, 40, 45, 49, 53, 55, 63, 71, 75, 78, 133, 134, 138, 245, 247, 251–254]. CEUS may improve results of pancreatic imaging, being nearly as accurate as CT-scan and reducing radiation exposure in children [249, 255, 256].…”

Section: Methodsmentioning

confidence: 99%

Duodeno-pancreatic and extrahepatic biliary tree trauma: WSES-AAST guidelines

et al. 2019

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Duodeno-pancreatic and extrahepatic biliary tree injuries are rare in both adult and pediatric trauma patients, and due to their anatomical location, associated injuries are very common. Mortality is primarily related to associated injuries, but morbidity remains high even in isolated injuries. Optimal management of duodeno-bilio-pancreatic injuries is dictated primarily by hemodynamic stability, clinical presentation, and grade of injury. Endoscopic and percutaneous interventions have increased the ability to non-operatively manage these injuries. Late diagnosis and treatment are both associated to increased morbidity and mortality. Sequelae of late presentations of pancreatic injury and complications of severe pancreatic trauma are also increasingly addressed endoscopically and with interventional radiology procedures. However, for moderate and severe extrahepatic biliary and severe duodeno-pancreatic injuries, immediate operative intervention is preferred as associated injuries are frequent and commonly present with hemodynamic instability or peritonitis. The aim of this paper is to present the World Society of Emergency Surgery (WSES) and American Association for the Surgery of Trauma (AAST) duodenal, pancreatic, and extrahepatic biliary tree trauma management guidelines.

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“…In children - if possible - one should perform the examinations which have the least negative biological effects possible, such as ultrasonography or MR examination. When it comes to the examinations following abdominal trauma, a comprehensive analysis performed by Zhou et al showed that ultrasonography examinations have a high sensitivity, specificity and accuracy − 91.9%, 96.9% and 96.6%, respectively, in comparison with CT examination, diagnostic peritoneal lavage, repeated ultrasonography examination, cystography, surgery and clinical observation [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Clinically Unjustified Diagnostic Imaging – a Worrisome Tendency in Today’s Medical Practice

Sobiecka

Bekiesińska‐Figatowska²,

Rutkowska

et al. 2016

Pol J Radiol

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SummaryBackgroundThe purpose of the study was to evaluate the percentage of unjustified examinations among all the CT and MRI studies performed by two radiology departments and to determine the types of examinations which are most commonly carried out unnecessarily.Material/MethodsThree radiologists assessed the justification of CT and MRI examinations performed during a period of 14 days based on the referrals. The radiologists assessed 799 referrals for CT scans (847 examinations of a particular part of the body) and 269 MRI referrals (269 examinations). The criteria for justification were: medical expertise and the guidelines. During the first stage radiologists divided the examinations into 3 groups: justified, unjustified and the examinations of questionable justification. The second step was to determine the reasons why the studies were considered as unjustified or of questionable justification.Results73 of 1116 examinations (6.54%) were considered to be unjustified or of a questionable justification. There were 59 CT scans (59/847=6.97%) and 14 MRI studies (14/269=5.20%). The most common reasons to consider them as unjustified or of questionable justification were: inadequate method of diagnostic imaging chosen as a first-line tool and lacking or insufficient clinical details.ConclusionsIn our investigation 6.54% of both CT and MRI examinations were considered as unjustified or of questionable justification, which is lower than described in other studies (from 7% to 26%). The assessment was based only on referrals, therefore a total share of these examinations is likely to be higher.

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Screening ultrasonography of 2,204 patients with blunt abdominal trauma in the Wenchuan earthquake

Abstract: Diagnostic study, level III.

Cited by 19 publications

References 16 publications

Accuracy of Focused Assessment with Sonography for Trauma (FAST) in Disaster Settings: A Meta-Analysis and Systematic Review

Accuracy of Focused Assessment with Sonography for Trauma (FAST) in Disaster Settings: A Meta-Analysis and Systematic Review

Duodeno-pancreatic and extrahepatic biliary tree trauma: WSES-AAST guidelines

Clinically Unjustified Diagnostic Imaging – a Worrisome Tendency in Today’s Medical Practice

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