Santichatngam’s Colonic Injury Prediction Score (SCOPES)
Keywords:Clinical predictive score, colonic injury
Background: Colonic injury is one of the common intra-abdominal organ injuries. The management of colonic injury has undergone many radical changes in the last few decades from all diversion to selected primary repair. So far, there has been no clinical predictive score for selection of treatment in patients with colonic injury.
Objective: To develop the clinical predictive score for treatment selection in patients with colonic injury.
Patients and Methods: Patients with colonic injury who were treated at Maharat Nakhon Ratchasima Hospital were recruited from Oct 1, 2008 to Sep 30, 2014. Retrospective chart review was performed.
Results: I developed the Santichatngam’s Colonic Injury Prediction Score (SCOPES) using the following variables: weights; delayed time to surgery >6 hours (+2.56); gross fecal contamination (+4.19); left-sided colonic injury (+2.32); and duodenal/ureteral injury (+3.48). The positive SCOPES (score > 4.87 by >2 factors) had the following accuracy indices: sensitivity 88.24%; specificity 83.51%; likelihood ratio for positive results 5.35; and likelihood ratio for negative results 0.14. In validation phase, the probability of the SCOPES after a positive score was 84.25% for diversion and probability of the SCOPES after a negative score was 87.72% for primary repair.
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