Abdominal injury score: a clinical score for the assignment of risk in children after blunt trauma.

Abstract

To develop a clinical scoring scheme that can be used to predict the risk of abdominal injury in children after blunt trauma. Presenting clinical features and outcomes, including the need for surgery, were reviewed for 793 children who underwent computed tomography (CT) after blunt abdominal trauma. These data were submitted to a logistic regression model to identify predictors for major abdominal injury. An abdominal injury score was developed on the basis of results of these analyses; higher scores denoted a progressively higher risk. The proportion of children with abdominal injury increased significantly with progressively higher scores (P = .0001). There was no significant difference between the predicted and actual frequency distributions of abdominal injury (P = .782). Patients were assigned to low-, intermediate-, and high-risk groups according to abdominal injury score, with a predicted probability of abdominal injury for each group of < or = 5%, 6%-15%, and > or = 16%, respectively. Frequency of major abdominal injury increased with higher scores, as did the need for laparotomy. The abdominal injury score shows promise as a useful tool for triage of children considered for emergency CT after blunt abdominal trauma.