Afifi Raafat Y
Int J Surg. 2008 Apr;6(2):91-5. doi: 10.1016/j.ijsu.2006.09.005. Epub 2006 Oct 24.
Abdominal trauma poses a diagnostic challenge to most trauma surgeons. This study evaluates a clinical scoring system in 476 blunt abdominal trauma patients treated by the author over a period of 92 months. Patients were sorted into three groups according to the score results. Priority I group (160 patients) was subjected to an immediate laparotomy. Priority II group (200 patients) was treated according to the results of auxiliary investigations. Priority III group (116 patients) was kept under observation. The treatment outcome was used as a gold standard for the evaluation of the results.
In priority I and III groups (276 cases) the management was only dependent on the proposed clinical score with a 100% specificity, 88% sensitivity, 90% positive predictive value, 100% negative predictive value and an overall accuracy of 94%.
This scoring system (CASS) is helpful in ensuring rapid diagnosis and treatment, reduces time, costs and mortality that may result from improper and/or delayed diagnosis.
腹部创伤对大多数创伤外科医生来说是一个诊断难题。本研究评估了作者在92个月内治疗的476例钝性腹部创伤患者的一种临床评分系统。根据评分结果将患者分为三组。I级优先组（160例患者）立即接受剖腹手术。II级优先组（200例患者）根据辅助检查结果进行治疗。III级优先组（116例患者）进行观察。治疗结果作为评估结果的金标准。
在I级和III级优先组（276例）中，治疗仅依赖于所提出的临床评分，特异性为100%，敏感性为88%，阳性预测值为90%，阴性预测值为100%，总体准确率为94%。
这种评分系统（CASS）有助于确保快速诊断和治疗，减少因诊断不当和/或延迟诊断而导致的时间、成本和死亡率。
