Hemoperitoneum score helps determine need for therapeutic laparotomy

Purpose Sonography provides a fast, portable, and noninvasive method for pa tient assessment. However, the benefit of providing real-time ultrasound (U S) imaging and fluid quantification shortly after patient arrival has not b een explored, The objective of this study was to prospectively validate a U S hemoperitoneum scoring system developed at our institution and determine whether sonography can predict a therapeutic operation. Methods: For 12 months, prospective data on all patients undergoing a traum a sonogram were recorded. All sonograms positive for free fluid were given a hemoperitoneum score, The US scare was compared with initial systolic blo od pressure and base deficit to assess the ability of sonography to predict a therapeutic laparotomy. Results: Forts of 46 patients (87%) with a US score greater than or equal t o 3 required a therapeutic laparotomy, Forty-six of 54 patients with a US s tore < 3 (85%) did not need operative intervention. The sensitivity of sono graphy was 83% compared with 28% and 49% for systolic blood pressure and ba se deficit, respectively, in determining the need for therapeutic operation . Conclusion: We conclude that the majority of patients with a score <greater than or equal to> 3 will need surgery. The US hemoperitoneum scoring syste m was a better predictor of a therapeutic laparotomy than initial blood pre ssure and/or base deficit.