Patients who leave a public hospital emergency department without being seen by a physician: Baker DW, Stevens CD, Brook RH JAMA 266:1085–1090 Aug 1991
✍ Scribed by David Magid
- Book ID
- 104311031
- Publisher
- Elsevier Science
- Year
- 1992
- Tongue
- English
- Weight
- 90 KB
- Volume
- 21
- Category
- Article
- ISSN
- 1097-6760
No coin nor oath required. For personal study only.
✦ Synopsis
ABSTRACTS
injury. Of 13 patients with negative lavage by lavage RBC but LAP _> 3 IU/L, seven (54%) sustained significant intra-abdominal injury, and in six of these patients LAM was > 20 IU/L. LAP _> 3 IU/L had a sensitivity of 54%, a specificity of 98%, and a positive predictive value of 54% for significant intra-abdominal injury. LAM _> 20 IU/L and LAP _> 3 IU/L combined had sensitivity of 54%, specificity of 98%, and a positive predictive value of 88% for significant intra-abdominal injury. Ten patients in the study had an elevated LAM, LAP, or both as the only objective laboratory evidence of significant intra-abdominal injury. The authors advocate routinely assaying LAM and LAP and suggest that laparotomy is mandatory when these enzymes are elevated and the history is consistent with possible small-bowel injury.