Table 6.
Accuracy of Combinations of Findings to Identify Intra-abdominal Injury From Evidence Level 1 to 3 Studies
| Combination | Sensitivity, % (95% CI) | Specificity, % (95% CI) | Positive Likelihood Ratio (95% CI) | Negative Likelihood Ratio (95% CI) |
|---|---|---|---|---|
| Abnormal mental status, abdominal guarding, or abdominal tenderness25 | 65 (53–75) | 75 (71–79) | 2.6 (2.0–3.2) | 0.47 (0.34–0.65) |
| Abnormal mental status, abdominal guarding, abdominal tenderness, abnormal FAST examination result, or abnormal chest radiograph25 | 89 (80–94) | 36 (32–40) | 1.4 (1.3–1.5) | 0.31 (0.17–0.58) |
| Hematuria (≥25 RBCs/high-power field), abnormal chest radiograph, abdominal tenderness, GCS score <14, costal margin tenderness, femur fracture, or hematocrit <30%17 | 97 (95–99) | 28 (26–29) | 1.3 (1.3–1.4) | 0.10 (0.06–0.17) |
| Abnormal mental status, abdominal guarding, abdominal tenderness, AST >50 U/L, WBC count >10 000 cells/μL, or hematocrit <36%25 | 99 (94–100) | 19 (16–22) | 1.2 (1.2–1.3) | 0.06 (0.01–0.45) |
| Abnormal mental status, abdominal guarding, abdominal tenderness, AST >50 U/L, WBC count >10 000 cells/μL, hematocrit <36%, abnormal FAST examination result, or abnormal chest radiograph25a | 100 (95–100) | 12 (9–15) | 1.1 (1.1–1.2) | 0.05 (0.00–0.80) |
Abbreviations: AST, aspartate aminotransferase; FAST, Focused Assessment with Sonography for Trauma; GCS, Glasgow Coma Scale; RBC, red blood cell; WBC, white blood cell.
a
0.5 was added to each cell of the 2 × 2 table to obtain the upper 95% CI for the 100% sensitivity result.