Santichatngam’s Colonic Injury Prediction Score (SCOPES) for Decision Making in Colonic Injury Due to Trauma
Keywords:
Clinical prediction score, Colonic injuryAbstract
Objective: Santichatngam's Colonic Injury PrEdiction Score (SCOPES), which was developed in 2017, can assist in surgical decision making for colonic injury, i.e., whether primary repair can be performed or diversion is needed. The aim of the present study was to demonstrate the validity and utility of SCOPES for appropriate surgical decision making in at least grade 3 colonic injury.
Patients and Methods: Medical records of patients with colonic injury who were treated at Maharat Nakhon Ratchasima Hospital from October 1st, 2013 to September 30th, 2019, were reviewed. Two versions of SCOPES were created. Both versions consisted of four factors. In SCOPES version I, if only 1 factor were present, then primary repair is recommended. In SCOPES version II, in the presence of at least 2 major factors, or 1 major factor plus at least 1 minor factor, then a diversion procedure is recommended. The SCOPES recommendation was compared to a reference standard, which was determined by successful operative management and peer review.
Result: The SCOPES version I has a sensitivity of 81%, specificity of 86%, positive likelihood ratio of 5.7, positive predictive value of 96%, and accuracy of 82% for primary repair. The SCOPES version II has a sensitivity of 43%, specificity of 100%, positive likelihood ratio over 10, positive predictive value of 100%, and accuracy of 90% for colonic diversion. Application of SCOPES was useful in decision making in 74% of patients.
Conclusions: The present study demonstrated that SCOPES has good validity and utility in terms of recommending appropriate management. The use of SCOPES in clinical practice may have some advantages over clinical judgment alone.
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