Pulse Pressure: A Predictor of Intervention in Blunt Abdominal Trauma

Abstract

Background: Patients with life-threatening hemorrhage due to blunt torso trauma are at a particularly high risk of being under-diagnosed. The pulse pressure starts narrowing down before the traditional parameters start changing, making it a useful tool for assessing and planning early intervention. Objective: Toassess the utility of low pulse pressure in predicting massive transfusion or operative intervention in patients with isolated blunt torso trauma. Material and Methods: total of 186 patients were included. The pulse pressure and mean arterial pressure were calculated. Vitals, pulse pressure, and mean arterial pressure were monitored every 15 min during the first 6 h, then every 30 min during the next 6 h and afterwards, every 4 h until discharge. Chi-square test and an independent t-test (as appropriate) were applied to compare variables with pulse pressure at the time of presentation. A Differences were considered as statistically significant at p-value ≤ 0.05. Results: total of 55.9% of these patients had injuries due to road traffic accidents. Emergency operative intervention was provided to 26.3% of the patients. Death was 4.3%. Massive transfusion was required by 26.3% of the patients. There was a statistically significant association between low pulse pressure and sex, length of stay, repeat eFAST, emergency operational intervention, outcome, massive transfusion, number of crystalloids consumed within the first four hours after presentation, injury severity score, systolic blood pressure, and pulse rate. Conclusion: The pulse pressure <30 mmHg was observed as an independent predictor for increased blood loss requiring blood transfusion or operative intervention.