How Well Does CT Predict the Need for Laparotomy in Hemodynamically Stable Patients With Penetrating Abdominal Injury? A Review and Meta-Analysis

Cyle S. Goodman, Jee Y. Hur Marc A. Adajar, Curtis H. Coulam

OBJECTIVE. The objective of our study was to determine how well CT predicts the need for laparotomy in hemodynamically stable patients with penetrating abdominal injury.

MATERIALS AND METHODS. We reviewed MEDLINE articles published from Jan­uary 1994 through June 2008. The sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and accuracy were calculated for each source and collective­ly using a meta-analysis.

RESULTS. Of 180 relevant studies, five were included in the meta-analysis. Pooled weighted estimates of sensitivity, specificity, NPV, PPV, and accuracy were 94.90%, 95.38%, 98.62%, 84.51%, and 94.70%, respectively.

CONCLUSION. CT in patients with penetrating abdominal trauma has high sensitivity, specificity, NPV, and accuracy, but has lower PPV in determining the need for laparotomy. It follows that CT is an indispensable tool in predicting the need for laparotomy in these patients but still has room for improvement.