ASSESSMENT OF BATSS (BLUNT ABDOMINAL TRAUMA SCORING SYSTEM) IN PATIENTS OF BLUNT ABDOMINAL TRAUMA.
Objective: To apply Blunt Abdominal Trauma Scoring System (BATSS) to all patients of polytrauma and to evaluate its role in planning management and predicting outcome of patients with blunt abdominal trauma.
Material and Methods: An observational study was undertaken applying BATSS to polytrauma patients, visiting the Emergency department at Himalayan Institute of Medical Sciences, over a period of 12 months (January 2018 to December 2018) and then recording management protocol done for the patients with blunt abdominal trauma. Outcome assessment was done at 72 hours.
Results: The study included 95 patients of which 46% were in the age group of 20-40 years and 84% were males. The most common mechanism of trauma was road traffic accidents (67%) followed by fall from height. Specific organ injuries were found in 59% of the cases and of all the organ injuries recorded, 38% were injuries to the liver and 34% to the spleen.
BATSS was applied to all patients and 57% patients fell in the high risk category, 4% in moderate risk and 39% in the low risk category. Overall, 21% of all the cases underwent operative management while 79% were managed non operatively. Among the high risk category patients, 65% were managed with non-operative management and no mortality was recorded in these cases.
Conclusion: BATSS was found to be a useful tool for clinical grading of trauma patients in the emergency department but was not found adequate for deciding management or predicting outcome of patients with blunt abdominal trauma in this study cohort.
Keywords: BATSS, Abdominal trauma, Non-operative management
1. Musalar E, Ersel M, Akarca FK, Kıyan GS, Can Ö. The predictive value of biochemical parameters in evaluating patients with abdominal trauma: The new scoring system. Turk J Emerg Med. 2017 Jan 4;17(2):48–55.
2. road accidents in India 2017.pdf [Internet]. [cited 2019 May 4]. Available from: http://www.indiaenvironmentportal.org.in/files/file/road%20accidents%20in%20India%202017.pdf
3. Weledji P, Tambe J. Perspectives on the Management of Abdominal Trauma. J Univers Surg [Internet]. 2018 Jul 26 [cited 2019 Mar 29];6(3). Available from: http://www.jusurgery.com/abstract/perspectives-on-the-management-of-abdominal-trauma-23106.html
4. Lubner M, Menias C, Rucker C, Bhalla S, Peterson CM, Wang L, et al. Blood in the Belly: CT Findings of Hemoperitoneum. RadioGraphics. 2007 Jan 1;27(1):109–25.
5. Shojaee M, Faridaalaee G, Yousefifard M, Yaseri M, Arhami Dolatabadi A, Sabzghabaei A, et al. New scoring system for intra-abdominal injury diagnosis after blunt trauma. Chin J Traumatol Zhonghua Chuang Shang Za Zhi. 2014;17(1):19–24.
6. Shojaee M, Faridaalaee G, Yousefifard M, Yaseri M, Arhami Dolatabadi A, Sabzghabaei A, et al. New scoring system for intra-abdominal injury diagnosis after blunt trauma. Chin J Traumatol Zhonghua Chuang Shang Za Zhi. 2014;17(1):19–24.
7. Agarwal VK, Agrawal S. Conservative management and outcome of blunt trauma abdomen. Int Surg J. 2017 Feb 25;4(3):926–8.
8. Jones EL, Stovall RT, Jones TS, Bensard DD, Burlew CC, Johnson JL, et al. Intra-abdominal injury following blunt trauma becomes clinically apparent within 9 hours. J Trauma Acute Care Surg. 2014 Apr;76(4):1020–3.
9. Tinkoff G, Esposito TJ, Reed J, Kilgo P, Fildes J, Pasquale M, et al. American Association for the Surgery of Trauma Organ Injury Scale I: spleen, liver, and kidney, validation based on the National Trauma Data Bank. J Am Coll Surg. 2008 Nov;207(5):646–55.
10. Nishijima DK, Simel DL, Wisner DH, Holmes JF. Does this adult patient have a blunt intra-abdominal injury? JAMA. 2012 Apr 11;307(14):1517–27.
11. Okuş A, Sevinç B, Ay S, Arslan K, Karahan Ö, Eryılmaz MA. Conservative management of abdominal injuries. Turk J SurgeryUlusal Cerrahi Derg. 2013 Dec 1;29(4):153–7.
12. Osler T, Glance LG, Hosmer DW. Complication-Associated Mortality Following Trauma: A Population-Based Observational Study. Arch Surg. 2012 Feb 20;147(2):152–8.
13. Chaudhry R, Tiwari G, Singh Y. Damage Control Surgery for Abdominal Trauma. Med J Armed Forces India. 2006 Jul;62(3):259–62.