The Annals of African Surgery (Jul 2017)
Base Deficit as an Indicator of Significant Blunt Abdominal Trauma
Abstract
Background: Blunt abdominal trauma (BAT) is an important cause of morbidity and mortality among trauma patients. Base deficit (BD) has been proposed as an early available tool alongside focused assessment with sonography for trauma (FAST) in the screening of patients suspected to have BAT and also to help guide the selective use of CT scan. Objective: To determine the use of BD as an indicator of significant BAT. Methods: This was an observational study carried out at the Kenyatta National Hospital from February to May 2015. Patient with suspected BAT admitted into Accident & Emergency were enrolled. Data collected included clinical assessment, BD, FAST findings, CT-scan, and laparotomy were recorded. Data was analyzed using SPSS 17.0. Comparison of mean values of BD between different groups of patients (dischargedfrom A&E, managed conservatively or operated) was performed using ANOVA. Results: Patients who had significant abdominal injury had sensitivity and specificity of 82.98% and 65.91 % respectively at BD of -4.15.The PPV and NPV were 56.52% and 87.88 % respectively. At this cut-off point, AUC was 0.863 (p=0.037). Conclusion: Due to high NPV, BD could rule out significant abdominal injuries but can also predict need for exploratory laparotomy when less than -6.85.
