The role of plasma ammonia level in detecting intra-abdominal hemorrhage following blunt abdominal trauma

Abstract

Background:Blunt abdominal injury is a major cause of death in trauma cases. It will be very helpful if intra-abdominal bleeding can be predicted by laboratory tests. The aim of our study is to evaluate the accuracy of plasma ammonia in detecting intra-abdominal hemorrhage in patients with blunt abdominal injury.Materials and Methods:In this study, 60 patients admitted to Azadi teaching hospital complaining from blunt abdominal trauma were included. On admission to emergency room, plasma ammonia levels were measured. Demographic data, vital signs, and GCS reports were written down. Findings of abdomino-pelvic computed tomography scan and intraoperative laparotomy were supposed as a gold standard for abdominal injuries. We excluded patients with preexisting liver diseases or impairment.Results:In this study 60 patients were involved. 6 patients had intra-abdominal bleeding and their mean plasma ammonia level was much higher than the rest. (205.33±100.2 vs. 51.29±23.38, P < 0.001). ROC curve analysis revealed Accuracy 96.7% Sensitivity 83.3% Specificity 98.1%.Conclusion:The study results advocate that an increase in plasma ammonia level in patients with blunt abdominal trauma would be a useful predictor for intra-abdominal hemorrhage. This can be a great opportunity for hospitals lacking advanced facilities like contrast enhanced CT scan or diagnostic laparoscopy.