Jagjit Sri Devi, Rupp Jordan, Ferre Robinson M, Jordan Mary Kate, Bales Brian
Georgetown Public Hospital Corporation, New Market St., Georgetown, Guyana.
Vanderbilt Medical Center, 1313 21st Avenue South, Oxford House 703, Nashville, TN, 37212, USA.
Ultrasound J. 2020 Nov 26;12(1):48. doi: 10.1186/s13089-020-00194-3.
Systematic Sonography Looking for Occult Wounds (SSLOW) in trauma is a novel technique for the evaluation of intra-abdominal wounds in penetrating trauma. No data exist regarding the effectiveness. The objective of this study was to evaluate the accuracy of the SSLOW exam.
This is a prospective collected case series conducted over a period of 10 months and took place at the Accident and Emergency Department (A&E) of the Georgetown Public Hospital Corporation (GPHC). The study enrolled patients presenting to the A&E who were 16 years old or greater with penetrating abdominal trauma. All patients with penetrating trauma received an E-FAST examination. If the E-FAST examination was negative, a SSLOW examination was completed. The sonographer evaluated for free fluid collection between the loops of bowel. The results of the SSLOW were compared to usual care (surgery consult, serial abdominal and E-FAST exams, laparotomy, and 7-day follow-up) and then categorized into four groups: true positive, false positive, true negative, and false negative. These results lead to four categorical values. From these results, sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratios were calculated.
There were 5 (12%) true positives, 1 (2%) false positive, 37 (86%) true negatives, and zero (0%) false negative. The SSLOW was 100% sensitive (95% CI 5-100%) and 97% specificity (95% CI 74-96%). There was an 80% positive predictive value (95% CI 1.0-64% 95% CI) and 100% negative predictive value (95% CI 88-100%). The positive likelihood ratio was 8.4 (95% CI 3.69-19.1) and negative likelihood ratio was 0.
The SSLOW examination may be a useful tool in the evaluation of penetrating abdominal injuries.
创伤中系统超声检查寻找隐匿性伤口（SSLOW）是一种用于评估穿透性创伤中腹部伤口的新技术。目前尚无关于其有效性的数据。本研究的目的是评估SSLOW检查的准确性。
这是一项前瞻性收集的病例系列研究，为期10个月，在乔治敦公立医院集团（GPHC）急诊科进行。该研究纳入了年龄在16岁及以上、因穿透性腹部创伤就诊于急诊科的患者。所有穿透性创伤患者均接受了扩展创伤重点超声评估（E-FAST）检查。如果E-FAST检查结果为阴性，则完成SSLOW检查。超声检查人员评估肠袢之间是否有游离液体聚集。将SSLOW的结果与常规护理（手术会诊、系列腹部检查和E-FAST检查、剖腹手术以及7天随访）进行比较，然后分为四组：真阳性、假阳性、真阴性和假阴性。这些结果产生四个分类值。根据这些结果，计算敏感性、特异性、阳性预测值、阴性预测值和似然比。
有5例（12%）真阳性、1例（2%）假阳性、37例（86%）真阴性和0例（0%）假阴性。SSLOW的敏感性为100%（95%可信区间5%-100%），特异性为97%（95%可信区间74%-96%）。阳性预测值为80%（95%可信区间1.0%-64% 95%可信区间），阴性预测值为100%（95%可信区间88%-100%）。阳性似然比为8.4（95%可信区间3.69-19.1），阴性似然比为0。
SSLOW检查可能是评估穿透性腹部损伤的一种有用工具。
