A prospective evaluation of ultrasonography for the diagnosis of penetrating torso injury

Dror Soffer, Mark G. McKenney, Stephen Cohn, Raquel Garcia-Roca, Nicholas Namias, Carl Schulman, Mauricio Lynn, Peter Lopez, Juan Asensio, R. Stephen Smith, Steven M. Steinberg, Michael D. McGonigal

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Background: Ultrasound (US) is commonly used for the diagnosis of hemoperitoneum after blunt abdominal trauma, but the value of US as an aid for identification of operative lesions after penetrating trauma is not well documented. The purpose of this investigation was to determine the accuracy of US for the evaluation of penetrating torso trauma and to assess the impact of this information on patient management. Methods: We conducted a prospective cohort observational study of consecutive penetrating torso patients at a Level I trauma center. Results: During the 6-month trial period, 177 victims of penetrating torso trauma were assessed by our trauma teams. Ninety-two patients had stab wounds, 84 patients had gunshot wounds, and I patient had a puncture wound. All 28 patients with positive US examination had an exploratory laparotomy or thoracotomy (one patient had more than one procedure), resulting in 26 therapeutic operations. There were 149 negative US examinations, but in this group, 36 patients underwent laparotomy or thoracotomy, and 28 had therapeutic operations. The overall accuracy of the US examination was therefore 85%, the sensitivity was 48%, and the specificity was 98%. There were only three patients who had their initial management altered by a positive US examination. Conclusion: The US examination lacks sensitivity to be used alone in determining operative intervention after gunshot or stab wounds. Rarely does US information contribute to the management of patients with penetrating abdominal injuries.

Original languageEnglish
Pages (from-to)953-959
Number of pages7
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume56
Issue number5
StatePublished - May 2004

Fingerprint

Torso
Ultrasonography
Wounds and Injuries
Stab Wounds
Gunshot Wounds
Thoracotomy
Laparotomy
Hemoperitoneum
Abdominal Injuries
Trauma Centers
Punctures
Observational Studies
Cohort Studies

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Soffer, D., McKenney, M. G., Cohn, S., Garcia-Roca, R., Namias, N., Schulman, C., ... McGonigal, M. D. (2004). A prospective evaluation of ultrasonography for the diagnosis of penetrating torso injury. Journal of Trauma - Injury, Infection and Critical Care, 56(5), 953-959.

A prospective evaluation of ultrasonography for the diagnosis of penetrating torso injury. / Soffer, Dror; McKenney, Mark G.; Cohn, Stephen; Garcia-Roca, Raquel; Namias, Nicholas; Schulman, Carl; Lynn, Mauricio; Lopez, Peter; Asensio, Juan; Smith, R. Stephen; Steinberg, Steven M.; McGonigal, Michael D.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 56, No. 5, 05.2004, p. 953-959.

Research output: Contribution to journalArticle

Soffer, D, McKenney, MG, Cohn, S, Garcia-Roca, R, Namias, N, Schulman, C, Lynn, M, Lopez, P, Asensio, J, Smith, RS, Steinberg, SM & McGonigal, MD 2004, 'A prospective evaluation of ultrasonography for the diagnosis of penetrating torso injury', Journal of Trauma - Injury, Infection and Critical Care, vol. 56, no. 5, pp. 953-959.
Soffer D, McKenney MG, Cohn S, Garcia-Roca R, Namias N, Schulman C et al. A prospective evaluation of ultrasonography for the diagnosis of penetrating torso injury. Journal of Trauma - Injury, Infection and Critical Care. 2004 May;56(5):953-959.
Soffer, Dror ; McKenney, Mark G. ; Cohn, Stephen ; Garcia-Roca, Raquel ; Namias, Nicholas ; Schulman, Carl ; Lynn, Mauricio ; Lopez, Peter ; Asensio, Juan ; Smith, R. Stephen ; Steinberg, Steven M. ; McGonigal, Michael D. / A prospective evaluation of ultrasonography for the diagnosis of penetrating torso injury. In: Journal of Trauma - Injury, Infection and Critical Care. 2004 ; Vol. 56, No. 5. pp. 953-959.
@article{1270f5088d054ba4973cab7564a5f217,
title = "A prospective evaluation of ultrasonography for the diagnosis of penetrating torso injury",
abstract = "Background: Ultrasound (US) is commonly used for the diagnosis of hemoperitoneum after blunt abdominal trauma, but the value of US as an aid for identification of operative lesions after penetrating trauma is not well documented. The purpose of this investigation was to determine the accuracy of US for the evaluation of penetrating torso trauma and to assess the impact of this information on patient management. Methods: We conducted a prospective cohort observational study of consecutive penetrating torso patients at a Level I trauma center. Results: During the 6-month trial period, 177 victims of penetrating torso trauma were assessed by our trauma teams. Ninety-two patients had stab wounds, 84 patients had gunshot wounds, and I patient had a puncture wound. All 28 patients with positive US examination had an exploratory laparotomy or thoracotomy (one patient had more than one procedure), resulting in 26 therapeutic operations. There were 149 negative US examinations, but in this group, 36 patients underwent laparotomy or thoracotomy, and 28 had therapeutic operations. The overall accuracy of the US examination was therefore 85{\%}, the sensitivity was 48{\%}, and the specificity was 98{\%}. There were only three patients who had their initial management altered by a positive US examination. Conclusion: The US examination lacks sensitivity to be used alone in determining operative intervention after gunshot or stab wounds. Rarely does US information contribute to the management of patients with penetrating abdominal injuries.",
author = "Dror Soffer and McKenney, {Mark G.} and Stephen Cohn and Raquel Garcia-Roca and Nicholas Namias and Carl Schulman and Mauricio Lynn and Peter Lopez and Juan Asensio and Smith, {R. Stephen} and Steinberg, {Steven M.} and McGonigal, {Michael D.}",
year = "2004",
month = "5",
language = "English",
volume = "56",
pages = "953--959",
journal = "Journal of Trauma and Acute Care Surgery",
issn = "2163-0755",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - A prospective evaluation of ultrasonography for the diagnosis of penetrating torso injury

AU - Soffer, Dror

AU - McKenney, Mark G.

AU - Cohn, Stephen

AU - Garcia-Roca, Raquel

AU - Namias, Nicholas

AU - Schulman, Carl

AU - Lynn, Mauricio

AU - Lopez, Peter

AU - Asensio, Juan

AU - Smith, R. Stephen

AU - Steinberg, Steven M.

AU - McGonigal, Michael D.

PY - 2004/5

Y1 - 2004/5

N2 - Background: Ultrasound (US) is commonly used for the diagnosis of hemoperitoneum after blunt abdominal trauma, but the value of US as an aid for identification of operative lesions after penetrating trauma is not well documented. The purpose of this investigation was to determine the accuracy of US for the evaluation of penetrating torso trauma and to assess the impact of this information on patient management. Methods: We conducted a prospective cohort observational study of consecutive penetrating torso patients at a Level I trauma center. Results: During the 6-month trial period, 177 victims of penetrating torso trauma were assessed by our trauma teams. Ninety-two patients had stab wounds, 84 patients had gunshot wounds, and I patient had a puncture wound. All 28 patients with positive US examination had an exploratory laparotomy or thoracotomy (one patient had more than one procedure), resulting in 26 therapeutic operations. There were 149 negative US examinations, but in this group, 36 patients underwent laparotomy or thoracotomy, and 28 had therapeutic operations. The overall accuracy of the US examination was therefore 85%, the sensitivity was 48%, and the specificity was 98%. There were only three patients who had their initial management altered by a positive US examination. Conclusion: The US examination lacks sensitivity to be used alone in determining operative intervention after gunshot or stab wounds. Rarely does US information contribute to the management of patients with penetrating abdominal injuries.

AB - Background: Ultrasound (US) is commonly used for the diagnosis of hemoperitoneum after blunt abdominal trauma, but the value of US as an aid for identification of operative lesions after penetrating trauma is not well documented. The purpose of this investigation was to determine the accuracy of US for the evaluation of penetrating torso trauma and to assess the impact of this information on patient management. Methods: We conducted a prospective cohort observational study of consecutive penetrating torso patients at a Level I trauma center. Results: During the 6-month trial period, 177 victims of penetrating torso trauma were assessed by our trauma teams. Ninety-two patients had stab wounds, 84 patients had gunshot wounds, and I patient had a puncture wound. All 28 patients with positive US examination had an exploratory laparotomy or thoracotomy (one patient had more than one procedure), resulting in 26 therapeutic operations. There were 149 negative US examinations, but in this group, 36 patients underwent laparotomy or thoracotomy, and 28 had therapeutic operations. The overall accuracy of the US examination was therefore 85%, the sensitivity was 48%, and the specificity was 98%. There were only three patients who had their initial management altered by a positive US examination. Conclusion: The US examination lacks sensitivity to be used alone in determining operative intervention after gunshot or stab wounds. Rarely does US information contribute to the management of patients with penetrating abdominal injuries.

UR - http://www.scopus.com/inward/record.url?scp=2942750181&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=2942750181&partnerID=8YFLogxK

M3 - Article

C2 - 15179232

AN - SCOPUS:2942750181

VL - 56

SP - 953

EP - 959

JO - Journal of Trauma and Acute Care Surgery

JF - Journal of Trauma and Acute Care Surgery

SN - 2163-0755

IS - 5

ER -