Abdominal injury is the third leading cause of death due to trauma. In this study, it is aimed to investigate the level of detection of acute trauma pathologies by the emergency medicine physician assistant in abdominal tomography images taken in trauma patients. Contrast-enhanced abdominal tomography images of 207 patients who applied with trauma between 12.15.2020 and 12.15.2021 were included in this study. In order to evaluate the images of the patients, the evaluation of the emergency medicine physician assistant was compared with the radiology official report. Patients’ age, gender, current complaints, symptoms, trauma classification, injury sites accompanying abdominal injury, hospitalization status and mortality rates were analyzed. The statistical distribution of the
patients’ demographic and clinical information was calculated. The reports of the patients whose radiology official report was issued and the emergency medicine assistant forms were transferred to the SPSS program as “pathology exists” or “no pathology”. In the study, 79.2% (n=164) were male and 20.8% (n=43) were female. The median age was 33 years. In terms of interpretation of abdominal tomography, a statistically significant correlation was found between the radiologist and the emergency medicine physician assistant in the evaluation of liver, spleen and kidney; intra-abdominal and retroperitoneal hemorrhage, muscle and fascia injury of abdominal wall; vertebral, iliac, ischiatic, pubic bone, sacrum and femoral neck fracture. It was determined that 12.1% (n=25) of the patients
were admitted to the intensive care unit and 5.3% (n=11) were died. High sensitivity, specificity, positive and negative predictive values were found in the evaluation of abdominal contrast-enhanced tomography imaging of patients admitted to the emergency department due to trauma by the emergency medicine assistant. We think that these high accuracy values are due to emergency medicine physician assistant’s evaluation of the patient’s history, physical examination and imaging studies as a whole.
Centers for Disease Control and Prevention. Web-based injury statistics query and reporting system. 2020; Online at; https://www.cdc.gov/injury/wisqars/index.html
Novelline RA, Rhea JT, Bell T. Helical CT of abdominal trauma. Radiol Clin North Am. 1999;37:591-612. doi: 10.1016/s0033-8389(05)70113-5.
Soto JA, Anderson SW. Multidetector CT of blunt abdominal trauma. Radiology. 2012;265(3):678-93. doi: 10.1148/radiol.12120354.
Karpuz Ç. Acil servise başvuran hastalara çekilen toraks bilgisayarlı tomografilerin değerlendirilmesinde acil tıp uzmanlık öğrencilerinin tomografileri yorumlamadaki doğruluk ve güvenilirlik derecelerinin araştırılması. Specialization Thesis in Medicine, Uludağ Üniversitesi, Bursa, 2018; Online at; https://acikbilim.yok.gov.tr/handle/20.500.12812/700495
Sarsılmaz A, Kocakoç E. Abdominal travma. Trd Sem. 2016;4:299-312. doi: 10.5152/trs.2016.389
Guven R, Akca AH, Caltili C, Sasmaz MI, Kaykisiz EK, Baran S, et al. Comparing the interpretation of emergency department computed tomography between emergency physicians and attending radiologists: A multicenter study. Niger J Clin Pract. 2018;21(10):1323-1329. doi: 10.4103/njcp.njcp_22_18.
Vaziri S, Mosaddegh R, Rezai M, Mohammadi F, Ashari MA. Emergency Medicine Service Can Interpret Abdomino-Pelvic CT scans with Close to the Same Accuracy as Radiology Service. Journal of Critical Reviews. 2020;7(4):709-13. doi: 10.31838/jcr.07.04.132 8. Türkiye İstatistik Kurumu (TÜİK). Karayolu trafik kaza istatistikleri 2020. 2021; Online at; https://data.tuik.gov.tr/Bulten/Index?p=Road-Traffic-Accident-Statistics-2020-37436.
World Health Organization (WHO). Road traffic injuries. 2021; Online at; https://www.who.int/news-room/fact-sheets/detail/road-traffic-injuries.
Kirkpatrick AW, Brenneman FD, McLean RF, Rapanos T, Boulanger BR. Is clinical examination an accurate indicator of raised intra-abdominal pressure in critically injured patients? Can J Surg. 2000;43(3):207-11.
Kartal ZA, Kozacı N, Çekiç B, Beydilli İ, Akçimen M, Güven DS, et al. CT interpretations in multiply injured patients: comparison of emergency physicians and on-call radiologists. Am J Emerg Med. 2016;34(12):2331-35. doi: 10.1016/j.ajem.2016.08.044.
Bagheri-Hariri S, Ayoobi-Yazdi N, Afkar M, Farahmand S, Arbab M, Shahlafar N, et al. Abdominal and pelvic CT scan interpretation of emergency medicine physicians compared with radiologists' report and its impact on patients' outcome. Emerg Radiol. 2017;24(6):675-80. doi: 10.1007/s10140-017-1542-2.
Tillou A, Gupta M, Baraff LJ, Schriger DL, Hoffman JR, Hiatt JR, et al. Is the use of pan-computed tomography for blunt trauma justified? A prospective evaluation. J Trauma. 2009;67(4):779-87. doi: 10.1097/TA.0b013e3181b5f2eb.
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