Pavithra, A (2023) Efficiency of Blunt Abdominal Trauma Severity Score (BATSS) in Predicting the Necessity of Laparotomy in Blunt Abdominal Trauma. Masters thesis, Madras Medical College, Chennai.
Full text not available from this repository.Abstract
INTRODUCTION: Abdominal trauma is one of the most common causes among injuries caused due to road traffic accidents. Motor vehicle accidents account for 75 to 80% of blunt abdominal trauma. Blunt injury of abdomen is also a result of fall from height, assault with blunt objects. Sport injuries and fall from riding bicycle. Blunt abdominal trauma is usually not obvious. The knowledge in the management of blunt abdominal trauma has progressively increased due to the inpatient data gathered from different parts of the world. In spite of the best techniques and advances in diagnostic and supportive care, the morbidity and mortality remain at large. The reason for this could be due to the interval between trauma and hospitalization, delay in diagnosis, inadequate and lack of appropriate surgical treatment, post operative complications and associated trauma especially to head, thorax and extremities. In view of increasing number of vehicles and consequently road traffic accidents, this dissertation has been chosen to study the case of blunt abdominal trauma with reference to the patients presenting at RAJIV GANDHI GOVERNMENT GENERAL HOSPITAL, MADRAS MEDICAL COLLEGE, CHENNAI. AIMS AND OBJECTIVES: Abdominal trauma is the third leading cause of death in trauma patients after head and chest with majority of cases being non penetrating or so called BLUNT ABDOMINAL TRAUMA (BAT). The main causes of BAT are motor vehicle crashes, direct traumas and fall from height. More than 50% of mortalities due to crashes led BAT are preventable and under this circumstance IN TIME LAPAROTOMY plays a major role. However difficulty in diagnosing patients with intraabdominal injuries explains the real need for an accurate and in hand method to evaluate the patients who require further surgical intervention like laparotomy. Frequently FAST is used. Since the ability of FAST in determining the necessity of laparotomy is blurred, a better applicable scoring system for selection of patients suspected with BAT is sought to make easy triage to save time, reduce unnecessary CT scans, radiation exposures and cost for diagnosis and treatment. To obtain blunt abdominal trauma patients signs as well as clinical data and to clarify the accuracy, sensitivity, specificity, negative and positive predictive value of BLUNT ABDOMINAL TRAUMA SEVERITY SCORING (BATSS) and its effectiveness in predicting the need for laparotomy. MATERIAL AND METHODS: The study was carried out in Institute of General Surgery, MADRAS MEDICAL COLLEGE AND RAJIV GANDHI GOVERNMENT GENERAL HOSPITAL. All injured patients were brought to an emergency resuscitation area where primary-survey, resuscitation, and a secondary survey in a standard method were conducted and clinical findings noted. Pulse rate, saturation and blood pressure recorded and all basic blood investigations carried out. The Focused Assessment with Sonography for Trauma (FAST) investigation was performed during primary-survey, after securing airway and establishing adequate oxygenation/ ventilation. The FAST investigation was classified as positive (clearly showing fluid on at least one window), or negative. No quantitative score system will be used for the quantity of fluid seen. CONCLUSION: This scoring will help in better triage of the trauma patient on arrival and reduce the need for further imaging and reduce the time interval between arrival and surgical intervention. With reduction in need for further imaging, it also provides additional benefit by reducing exposure to unnecessary radiation, administration of contrast and reduction in costs, overcrowding of casualty departments and possibility of immediate referral to a tertiary care trauma centre due to inadequate infrastructure to manage a case of blunt abdominal trauma. We conclude by stating that the Blunt Abdominal Scoring System (BATSS) is an excellent predictor of intra-abdominal injury and can be used as a tool by physicians/paramedics in referral/monitoring of high-risk patients in a resource limited setting.
| Item Type: | Thesis (Masters) |
|---|---|
| Additional Information: | 220120100513 |
| Uncontrolled Keywords: | Efficiency, Blunt Abdominal Trauma Severity Score (BATSS), Predicting Necessity, Laparotomy, Blunt Abdominal Trauma. |
| Subjects: | MEDICAL > General Surgery > MEDICAL > General Surgery |
| Depositing User: | Subramani R |
| Date Deposited: | 15 Jan 2024 06:46 |
| Last Modified: | 19 Jan 2024 16:48 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/21303 |
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