الفهرس 
PolytraumaOnly 14 pages are availabe for public view
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Abstract
Polytrauma, a complex medical challenge often arising from incidents like road traffic accidents, falls, and assaults, demands a nuanced approach to assessment and management. The literature review delves into the intricacies of polytrauma, navigating through topics such as abdominal trauma assessment, diagnostic methodologies, and trauma scoring systems.
from the foundational ABCDE approach (Airway, Breathing, Circulation, Disability, and Exposure) to the sophisticated tools like Focused Assessment with Sonography for Trauma (FAST) and Computed Tomography (CT), the literature synthesizes an extensive body of knowledge. Trauma scoring systems, which play a pivotal role in guiding clinical decisions, are setting the stage for the study’s methodology and subsequent findings.
This prospective observational study conducted at Menoufia University Hospital aimed to evaluate the efficacy of the Blunt Abdominal Trauma Severity Score (BATSS) in predicting positive laparotomy findings and mortality in patients with blunt abdominal trauma.
The study, conducted between May 2022 and May 2023, included 243 patients aged over 18 years presenting with blunt abdominal trauma. Notably, patients with penetrating trauma, pediatrics, pregnant females, those with disturbed consciousness, and major trauma patients other than abdominal trauma were excluded. The study employed a thorough data collection process, including a detailed review of medical records, adherence to ethical considerations, thorough clinical examination, laboratory investigations, radiological investigations and standardized trauma management protocols.
The patient demographics indicated a predominance of males (67.9%), with the majority falling within the age groups of twenties and thirties. Road traffic accidents were the most common mode of trauma (70%).
The BATSS, a 24-point scoring system, categorized patients into low, intermediate, and high-risk groups based on their scores. Results revealed that 47.7% were low-risk, 20.2% intermediate, and 32.1% highrisk.
The study also investigated the prevalence of positive laparotomy findings, with 34.2% of patients undergoing laparotomy, among whom 83.1% had positive findings. Noteworthy affected organs included the spleen (16.5%), liver (9.1%), kidney (6.6%), and intestine (4.1%). The study’s findings align with existing literature on trauma scoring systems and abdominal trauma assessment.
The modification of the FAST score and the proposed adjustments to BATSS provide a nuanced approach to evaluating trauma severity, enhancing specificity in identifying patients requiring laparotomy. The emphasis on a cutoff point >15 for positive laparotomy findings and >16 for mortality prediction highlights the potential clinical utility of BATSS in guiding management decisions. This is particularly crucial in resourcelimited settings where access to advanced imaging like CT scans may be restricted.
The study’s focus on the association between BATSS scores and both laparotomy findings and mortality underscores the need for personalized and risk-stratified approaches in trauma care. While the study offers valuable insights, the generalizability of these findings should be interpreted with caution. Further multicenter validation studies involving diverse patient populations and healthcare settings are warranted to ascertain the reliability and applicability of the proposed modifications to BATSS.