Santichatngam’s Colonic Injury Prediction Score (SCOPES)

Authors

  • Prinya Santichatngam Department of Surgery, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima

Keywords:

Clinical predictive score, colonic injury

Abstract

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.

References

1. Beal AC Jr, Bricker DL, Alessi FJ, Whisennand HH, DeBakey ME. Surgical considerations in the management of civilian colon injuries. Ann Surg 1971;173:971-8.

2. Schrock TR, Christiansen N. Management of perforating injuries of the colon. Surg Gynecol Obstet 1972;135:65-8.

3. Arango A, Baxter CR, Shires GT. Surgical management of the traumatic injuries of the right colon. Twenty years of civilian experience. Arch Surg 1979;114:703-6.

4. Stone HH, Fabian TC. Management of perforating colon trauma. Ann Surg 1979;190:430-6.

5. Flint LM, Vitale GC, Ridchardson JD, Polk HC Jr. The injured colon: relationships of the management to complications. Ann Surg 1981;193:619-23.

6. Burch JM, Brock JC, Gevirtzman L, Felicino DV, Mattox KL, Jordan GL Jr, DeBakey ME. The injured colon. Ann Surg 1986; 203:701-11.

7. Lucas CE, Ledgerwood AM. Management of the injured colon. Curr Surg 1986; 43 :190-3.

8. Shrock TR. Trauma to the colon and rectum. In: Blaisdell FW, Trunkey DD, editors. Abdominal trauma. New York, Thieme-Stratton Inc; 1982. p. 165-84.

9. Nance FC .Injury to the colon and rectum. In: Moore EE, Matox KL, Feliciano DV, editors. Trauma. Norwalk, Connecticut, Appleton&Lance; 1991. p. p521-32.

10. Dellinger EP. Oreskovich MR, Wertz MJ, Hamasaki V, Lennard ES. Risk of infection following laparotomy for penetrating abdominal injury. Arch Surg 1984;119:20-7.

11. Levision MA, Thomas DD, Wiencek RG, Wilson RF. Management of the injured colon: Evoluing practice at urban trauma center. Am J Surg 1990; 247: 247-51.

12. Falcone RE, Carcy LC. Colorectal trauma. Surg Clin North Am 1988;68:1307-18.

13. Woodhall JP, Ochsner A. The management of perforating injuries of the colon and rectum in civilian practice. Surgery 1951;27:305-20.

14. Okies JE, Bricker DL, Jordan BL, Beall AC Jr, DeBakey ME. Exteriorized repair of colon injuries. Am J Surg 1972; 124: 807-10.

15. Matolo NM, Woleman ER. Primary repair of colon injuries: A critical evaluation. J trauma 1977;17:554-6.

16. Kirkpatrick JR. The exterioized anastomosis: Its role in surgery of colon. Surgery 1977;82:362-5.

17. Dang CV, Peter ET, Park SN, Ellyson JH. Trauma of the colon: early drop-back of the exteriorized repair. Arch Surg 1982; 117:652-6.

18. Thompson JS, Moore EE. Factors affecting the outcome of exteriorized colon repairs. J Trauma 1982;22:403-6.

19. Nallathambi MN, Ivatury RR, Shah PM, Gaudino J, Stahl WM. Aggressive definitive management of penetrating colon injuries: 136 cases with 3.7 percent mortality. J Trauma 1984; 24:500-5.

20. Huber PJ, Thal ER. Management of colon injuries. Surg Clin North Am 1990;70:561-73.

21. Demetriades D, Murrey JA, Chan L, Ordonez C, Bowley D, Nagy KK, et al. Penetrating colon injuries requiring resection: diversion of primary anastomosis?. An AAST prospective multicenter study. J trauma 2001;50:765-75.

22. Burch JM. Injury to the colon and rectum. In: Moore EE, Mattox KL, Feliciano DV, editors. Trauma. New York: McGraw Hill; 2004. p. 735-53.

23. Hunt TK, Hawley RK, Dumphy JE. Aetiology of anatomic leakage. Proc Soc Med (supp l) 1970;63:28-30.

24. Josen AS, Ferrer JR JM, Forde KE, Zikria BA. Primary closure of colorectal wounds. Ann Surg 1972;176:782-6.

25. Stone HH, Fabian TC. Management of perforating colon trauma: Randomization between primary closure and exteriorization. Am Surg 1979;190:430-6.

26. Thomson JS, Moore EE, Moore JB. Comparison of penetrating injuries of the right and left colon. Ann Surg 1981;193:414-8.

27. Adkins BB, Zirkle PK, Waterhouse G .Penetrating colon trauma. J Trauma 1984;24:491-9.

28. Demetriades D, Rabinowitz B, Sofianos C, Prumm E. The management of colon injuries by primary repair or colostomy. Br J Surg 1985;72:881-3.

29. Shannon FL, Moore EE. Primary repair of the colon: When is it safe alternative. Surgery 1985;98:851-60.

30. Nelkin N, Lewis F. The influence of injury severity on complication rate after primary closure or colostomy of penetrating colon trauma. Ann Surg 1989;209:439-47.

31. George SM Jr, Fabian TC, Voeller GR, Kudsk KA, Mangiante EC, Britt LG. Primary repair of colon wounds. Ann Surg 1989; 209:728-43.

32. Stewart RM, Fabian TC, Croce MA, Pritchard FE, Minard G, Kudsk KA. Is resection with primary anastomosis following destructive colon wounds always safe. Am J Surg 1994;168: 316-9.

33. Murrey JA, Demetriades D, Colson M, Song Z, Velmahos GC, Comwell EE 3rd, et al. Colonic resection in trauma: Colostomy versus anastomosis. J Trauma 1999;46:250-4.

34. Nelson RL, Singer M. Primary repair for penetrating colon injuries. Cochrane Database of Systematic Reveiws 2003, Issue 3. Art. No. :CD002247. DOI: 10.1002/14651858.CD002247.

35. Kamwendo NY, Modiba MC, Matlala NS, Becker PJ. Randomized clinical trial to determine if delay from time of penetrating colonic injury precludes primary repair. Br J Surg 2002;89:993-8.

36. Ross SE, Cobean RA, Hoyt DB, Miller R, Mucha P Jr, Pietropaoli JA Jr, et al. Blunt colonic injury- a multicenter review. J Trauma 1992;33:379-84.
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Published

2017-06-29

How to Cite

1.
Santichatngam P. Santichatngam’s Colonic Injury Prediction Score (SCOPES). Thai J Surg [Internet]. 2017 Jun. 29 [cited 2024 Apr. 27];38(2):53-8. Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/219958

Issue

Vol. 38 No. 2 (2017): April - June

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Original Articles

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