Combination of liver enzymes, amylase and abdominal ultrasound tests have acceptable diagnostic values as an alternative test for abdominopelvic CT scan in blunt abdominal trauma

Abstract

Introduction: Abdominal trauma accounts for 15–20% of all-cause mortality of trauma. Abdominopelvic CT scan with intravenous contrast is considered the most accurate non-invasive diagnostic tool in detecting intra-abdominal injuries. In previous studies, rise in liver enzymes and amylase was associated with intra-abdominal injuries but the studies were not sufficient. Our aim was to assess the diagnostic values of liver enzymes and amylase for intra-abdominal injuries in blunt trauma patients. Methods: We included blunt abdominal trauma patients who referred to three teaching hospitals in 2018. The patients who had 14 years old or more and Glasgow Coma Scale above 8 were enrolled the study if the treating physician had high index of suspicion for intra-abdominal injuries and sent the patients for abdominopelvic CT scan with intravenous contrast. Sensitivity, specificity, positive and negative predictive values are calculated for results of liver enzymes, amylase and abdominal ultrasound. Results: Eventually, 300 patients with blunt abdominal trauma entered the study. Sensitivity, specificity, positive and negative predictive values of concurrent positive results of abdominal ultrasound, amylase and liver enzymes were 81.73 (95% CI, 73.2–88.1), 63.78 (95% CI, 65.36–70.61), 58.38 (95% CI, 56.36–70.61) and 84.89 (95% CI, 77.6–90.19), respectively. Conclusion: Considering findings of the present study, the combination of liver enzymes, amylase and abdominal ultrasound results can be an alternative method for detecting intra-abdominal injuries in patients in whom treating physicians have limitations such as overweight, instability of hemodynamic and lack of CT scan facility.