FAST for blunt abdominal trauma: Correlation between positive findings and admission acid-base measurement

Purpose: This study aimed to determine any association between positive findings in ultrasonography examination and initial BD valuewith regard to diagnosis of intra-abdominal bleeding following blunt abdominal trauma. Methods: A prospective, multi-center study of consecutive adult patients was performed from April to September 2015. Demographics, initial vital signs and arterial BDwere evaluated with respect to presence of any association with intra-abdominal bleeding and in-hospital mortality. FAST study was performed to find intra-abdominal bleeding. Receiver operating characteristic (ROC) curves tested the ability of BD to identify patients with intraabdominal hemorrhage and probable mortality. Results: A total of 879 patientswere included in final analysis. The mean (SD) agewas 36.68 (15.7) years and 714 patients (81.2%) were male. According tomultivariable analysis, statistically significant associationwas observed between negative admission BD and both intra-abdominal bleeding (OR 3.48, 95% CI 2.06-5.88, p < 0.001) and inhospital mortality (OR 1.55, 95% CI 1.49-1.63, p < 0.001). ROC curve analysis demonstrated sensitivity of 92.7% and specificity of 22.1% for the best cut-off value of BD (-8 mEq/L) to diagnose internal hemorrhage. Further, a cut-off value of-7 mEq/L demonstrated significant predictive performance, 94.8% sensitivity and 53.6% specificity for in-hospital mortality. Conclusion: This study revealed that arterial BD is an early accessible important marker to identify intra-abdominal bleeding, as well as to predict overall in-hospital mortality in patients with blunt abdominal trauma. (C) 2017 Published by Elsevier Inc.