The Predictive Value of Repeated Abdominal Ultrasonography in Patients with Multiple Trauma and Decreased Level of Consciousness: the Experience of a Resource-Limited Centre

Objective: to determine the predictive value of repeated abdominal ultrasonography in patients with multiple trauma and decreased level of consciousness (loc). methods: this prospective cross-sectional study was conducted over a six-month period at shahid rajaee trauma hospital, shiraz, iran. we included hemodynamically stable blunt abdominal trauma patients with a decreased loc (glasgow coma scale≤13) who were referred to the neurosurgery icu ward. included cases underwent 1 contrast-enhanced ct scan and two-time ultrasonographic study of the abdomen with an interval of 48 hours. the diagnostic accuracy of the ultrasonography was determined according to the ct-scan results. results: overall 80 patients with mean age of 37.75±18.67 years were included. there were 17 (21.3%) women and 63 (78.8%) men among the patients. compared with the ct-scan, the first ultrasonography showed a sensitivity of 60%, specificity of 80%, ppv of 16.60%, npv of 96.80%, and a diagnostic accuracy of 70%. the same values for the second ultrasonographic study were 80%, 79%, 20%, 98%, and 79%, respectively. in 4 (5%) patients whose first ultrasonography and ct scan results were negative, the second ultrasonography was positive for injury. conclusion: in patients with blunt trauma to the abdomen, when the only indication of abdominal ct scan is a decreased loc, two ultrasonographic studies can replace a ct imaging.