Role of plasma ammonia level in detecting intra-abdominal hemorrhage following blunt abdominal trauma
Background: Blunt abdominal injury is a leading cause of death in trauma patients. A reliable test predicting intra-abdominal hemorrhage would be a novel method. The study objective was to assess the diagnostic accuracy of plasma ammonia in detection of intra-abdominal bleeding in patients with blun...
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doaj-7dabb7c962ed43c29a416982d800fef42020-11-24T20:44:52ZengWolters Kluwer Medknow PublicationsJournal of Research in Medical Sciences1735-19951735-71362014-01-01191110801085Role of plasma ammonia level in detecting intra-abdominal hemorrhage following blunt abdominal traumaDavood FarsiAli Akbar Khademi FadakiNahid KianmehrSaeed AbbasiMahdi RezaiMohammad MarashiMani MofidiBackground: Blunt abdominal injury is a leading cause of death in trauma patients. A reliable test predicting intra-abdominal hemorrhage would be a novel method. The study objective was to assess the diagnostic accuracy of plasma ammonia in detection of intra-abdominal bleeding in patients with blunt abdominal trauma (BAT). Materials and Methods: In this observational study, all patients suffering from BAT, referred to our university teaching hospital included. The levels of ammonia were measured at the time of emergency department admission and 1 h after initial treatment. Demographic data, vital signs, and venous blood gas reports were recorded. Findings of contrast-enhanced abdominopelvic computed tomography scan and laparotomy were assumed as a gold standard for abdominal injuries. Results: A total of 104 patients was enrolled in the study. 15 patients (14.4%) had intra-abdominal hemorrhage and the mean plasma ammonia level in this group was significantly higher than the other patients on admission time (101.73 ± 5.41 μg/dL vs. 47.36 ± 26.31 μg/dL, P < 0.001). On receiver-operator characteristic curve analysis, in cutoff point of 89 μg/dL, the sensitivity, specificity, positive and negative likelihood ratios were 100% (95% confidence interval [CI], 79.6-100), 93.26% (95% CI, 86-96.8), 14.83 (95% CI, 6.84-32.12), and 0, respectively. Conclusion: The study findings suggest the measurement of ammonia level at the time of admission in the patients with BAT would be a useful test predicting intra-abdominal hemorrhage. Furthermore, decrease in the ammonia level could be a useful marker for monitoring response to treatment in these patients.http://www.jmsjournal.net/article.asp?issn=1735-1995;year=2014;volume=19;issue=11;spage=1080;epage=1085;aulast=FarsiBl1unt abdominal traumaintra-abdominal hemorrhageplasma ammonia level |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Davood Farsi Ali Akbar Khademi Fadaki Nahid Kianmehr Saeed Abbasi Mahdi Rezai Mohammad Marashi Mani Mofidi |
spellingShingle |
Davood Farsi Ali Akbar Khademi Fadaki Nahid Kianmehr Saeed Abbasi Mahdi Rezai Mohammad Marashi Mani Mofidi Role of plasma ammonia level in detecting intra-abdominal hemorrhage following blunt abdominal trauma Journal of Research in Medical Sciences Bl1unt abdominal trauma intra-abdominal hemorrhage plasma ammonia level |
author_facet |
Davood Farsi Ali Akbar Khademi Fadaki Nahid Kianmehr Saeed Abbasi Mahdi Rezai Mohammad Marashi Mani Mofidi |
author_sort |
Davood Farsi |
title |
Role of plasma ammonia level in detecting intra-abdominal hemorrhage following blunt abdominal trauma |
title_short |
Role of plasma ammonia level in detecting intra-abdominal hemorrhage following blunt abdominal trauma |
title_full |
Role of plasma ammonia level in detecting intra-abdominal hemorrhage following blunt abdominal trauma |
title_fullStr |
Role of plasma ammonia level in detecting intra-abdominal hemorrhage following blunt abdominal trauma |
title_full_unstemmed |
Role of plasma ammonia level in detecting intra-abdominal hemorrhage following blunt abdominal trauma |
title_sort |
role of plasma ammonia level in detecting intra-abdominal hemorrhage following blunt abdominal trauma |
publisher |
Wolters Kluwer Medknow Publications |
series |
Journal of Research in Medical Sciences |
issn |
1735-1995 1735-7136 |
publishDate |
2014-01-01 |
description |
Background: Blunt abdominal injury is a leading cause of death in trauma patients. A reliable test predicting intra-abdominal hemorrhage would be a novel method. The study objective was to assess the diagnostic accuracy of plasma ammonia in detection of intra-abdominal bleeding in patients with blunt abdominal trauma (BAT). Materials and Methods: In this observational study, all patients suffering from BAT, referred to our university teaching hospital included. The levels of ammonia were measured at the time of emergency department admission and 1 h after initial treatment. Demographic data, vital signs, and venous blood gas reports were recorded. Findings of contrast-enhanced abdominopelvic computed tomography scan and laparotomy were assumed as a gold standard for abdominal injuries. Results: A total of 104 patients was enrolled in the study. 15 patients (14.4%) had intra-abdominal hemorrhage and the mean plasma ammonia level in this group was significantly higher than the other patients on admission time (101.73 ± 5.41 μg/dL vs. 47.36 ± 26.31 μg/dL, P < 0.001). On receiver-operator characteristic curve analysis, in cutoff point of 89 μg/dL, the sensitivity, specificity, positive and negative likelihood ratios were 100% (95% confidence interval [CI], 79.6-100), 93.26% (95% CI, 86-96.8), 14.83 (95% CI, 6.84-32.12), and 0, respectively. Conclusion: The study findings suggest the measurement of ammonia level at the time of admission in the patients with BAT would be a useful test predicting intra-abdominal hemorrhage. Furthermore, decrease in the ammonia level could be a useful marker for monitoring response to treatment in these patients. |
topic |
Bl1unt abdominal trauma intra-abdominal hemorrhage plasma ammonia level |
url |
http://www.jmsjournal.net/article.asp?issn=1735-1995;year=2014;volume=19;issue=11;spage=1080;epage=1085;aulast=Farsi |
work_keys_str_mv |
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