Radiology, Vol 190, 689-694, Copyright © 1994 by Radiological Society of North America
Abdominal injury score: a clinical score for the assignment of risk in children after blunt trauma
GA Taylor, R O'Donnell, CJ Sivit and MR Eichelberger
Department of Radiology and Diagnostic Imaging, Children's National Medical Center, Washington, DC.
PURPOSE: To develop a clinical scoring scheme that can be used to predict
the risk of abdominal injury in children after blunt trauma. MATERIALS AND
METHODS: Presenting clinical features and outcomes, including the need for
surgery, were reviewed for 793 children who underwent computed tomography
(CT) after blunt abdominal trauma. These data were submitted to a logistic
regression model to identify predictors for major abdominal injury. An
abdominal injury score was developed on the basis of results of these
analyses; higher scores denoted a progressively higher risk. RESULTS: The
proportion of children with abdominal injury increased significantly with
progressively higher scores (P = .0001). There was no significant
difference between the predicted and actual frequency distributions of
abdominal injury (P = .782). Patients were assigned to low-, intermediate-,
and high-risk groups according to abdominal injury score, with a predicted
probability of abdominal injury for each group of < or = 5%, 6%-15%, and
> or = 16%, respectively. Frequency of major abdominal injury increased
with higher scores, as did the need for laparotomy. CONCLUSION: The
abdominal injury score shows promise as a useful tool for triage of
children considered for emergency CT after blunt abdominal trauma.
