Deciding who doesn’t need abdominal CT in trauma

A derivation then validation study on adults with blunt torso trauma found the absence of the following factors to be associated with a very low risk of significant (intervention-requiring) abdominal pathology and such patients were unlikely to benefit from abdominal CT scanning:

  • GCS score less than 14
  • costal margin tenderness
  • abdominal tenderness
  • femur fracture
  • hematuria level greater than or equal to 25 red blood cells/high powered field
  • hematocrit level less than 30%
  • abnormal chest radiograph result (pneumothorax or rib fracture)

Clinical Prediction Rules for Identifying Adults at Very Low Risk for Intra-abdominal Injuries After Blunt Trauma

Ann Emerg Med. 2009 Oct;54(4):575-8