Prospective study of the clinical predictors of a positive abdominal computed tomography in blunt trauma patients.

BACKGROUND

CT scans are often used in the evaluation of blunt trauma patients. Many scans are negative. Clinical predictors of positive abdominal CT scans would be beneficial in patient care.

METHODS

A prospective study of 213 patients at a Level I trauma center presenting with blunt trauma who underwent abdominal CT scan. Indications for CT scan were analyzed statistically, using univariate and multivariate models.

RESULTS

Univariate chi2 tests showed abnormal pelvis x-ray (p = 0.0002) and an intubated patient (p = 0.03) were predictors of a positive CT scan. When subjected to multivariate logistic regression, these two indications were significant predictors of a positive CT scan, abnormal pelvis x-ray (p = 0.0005, OR=6.6, 95% CI), and an intubated patient (p = 0.02, OR=2.6, 95% CI). Univariate chi2 tests also showed that alcohol intoxication was statistically significant predictor of a negative CT scan (p = 0.03).

CONCLUSION

Our data suggest that an abnormal pelvis x-ray and intubation are significant risk factors for a positive CT scan. Alcohol intoxication, mechanism of injury, and unreliable examination, without other associated indication for a scan, may warrant further study.