How Well Does CT Predict the Need for Laparotomy in Hemodynamically Stable Patients With Penetrating Abdominal Injury? A Review and Meta-Analysis
July 21st, 2009 Posted by: admin
OBJECTIVE. The objective of our study was to determine how well CT
predicts the need for laparotomy in hemodynamically stable patients with
penetrating abdominal injury.
MATERIALS AND METHODS. We reviewed MEDLINE articles published from
January 1994 through June 2008. The sensitivity, specificity, negative
predictive value (NPV), positive predictive value (PPV), and accuracy were
calculated for each source and collectively using a meta-analysis.
RESULTS. Of 180 relevant studies, five were included in the
meta-analysis. Pooled weighted estimates of sensitivity, specificity, NPV,
PPV, and accuracy were 94.90%, 95.38%, 98.62%, 84.51%, and 94.70%,
respectively.
CONCLUSION. CT in patients with penetrating abdominal trauma has
high sensitivity, specificity, NPV, and accuracy, but has lower PPV in
determining the need for laparotomy. It follows that CT is an indispensable
tool in predicting the need for laparotomy in these patients but still has
room for improvement.
