The Utility of the Inferior Vena Cava/Aorta Diameter Index in Trauma Patients

Son, Kang Ho; Kim, Mi Ran; Kim, Yang Weon; Yoon, Yoo Sang

Abstract

PURPOSE
An accurate assessment of body fluid status is a significant challenge during every clinical examination. In many disorders, the therapy and its effectiveness depend on appropriate evaluation of body fluid state, especially in the trauma patient. The purpose of this study was to evaluate the clinical significance of the IVC/aorta diameter index on abdominal CT scans and to determine whether? The IVC/aorta diameter index was useful for predicting the outcome of trauma patients in the emergency department.
METHODS
This study was a retrospective analysis of data acquired between December 2008 and April 2009. We included 108 trauma patients who received abdominal CT in the emergency department. Persons who had a major medical problem such as liver cirrhosis, or who were transferred from other hospitals for ICU care, or who were younger than 15 years, were excluded. IVC and aorta were measured below the infrarenal vein in the abdominal CT in an axial view. Clinical assessment included the patient's final diagnosis, blood pressure, heart rate, weight and whether he was dead or not. Receiver operating characteristic (ROC) curves were used to find the value of the IVC/aorta diameter index that maximized the sum of the sensitivity and specificity. Statistical analysis was performed using SPSS 17.0.
RESULTS
We studied 135 patients (trauma 108 and non trauma 27). The mean IVC/aorta diameter index of nontrauma patients was 1.26+/-0.17; for trauma patients it was 0.80+/-0.33. The average IVC/aorta index in the shock group at arrival were significantly smaller than in the non shock group (0.57+/-0.27 versus 0.89+/-0.3).
CONCLUSION
The inferior vena cava/aorta diameter index in trauma patients is useful in assessment of injury severity and prognosis.