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Article

Accuracy of Contrast Extravasation on Computed Tomography for Diagnosing Severe Pelvic Hemorrhage in Pelvic Trauma Patients: A Meta-Analysis

by 1,†, 2,† and 3,*
1
Department of Radiology, Wonkwang University Hospital, Iksan 54538, Korea
2
Department of Pathology, Eulji University School of Medicine, Uijeongbu Eulji University, Kyeonggi-do 11759, Korea
3
Department of Trauma Surgery, Wonkwang University School of Medicine, Wonkwang University Hospital, Iksan 54538, Korea
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Medicina 2021, 57(1), 63; https://doi.org/10.3390/medicina57010063
Received: 20 December 2020 / Revised: 9 January 2021 / Accepted: 10 January 2021 / Published: 12 January 2021
(This article belongs to the Special Issue Meta-Research in the Medico-Scientific Field)
Background and objective: The early detection of underlying hemorrhage of pelvic trauma has been a critical issue. The aim of this study was to systematically determine the diagnostic accuracy of computed tomography (CT) for detecting severe pelvic hemorrhage. Materials and Methods: Relevant articles were obtained by searching PubMed, EMBASE, and Cochrane databases through 28 November 2020. Diagnostic test accuracy results were reviewed to obtain the sensitivity, specificity, diagnostic odds ratio, and summary receiver operating characteristic curve of CT for the diagnosis in pelvic trauma patients. The positive finding on CT was defined as the contrast extravasation. As the reference standard, severe pelvic hemorrhage was defined as an identification of bleeding at angiography or by direct inspection using laparotomy that required hemostasis by angioembolization or surgery. A subgroup analysis was performed according to the CT modality that is divided by the number of detector rows. Result: Thirteen eligible studies (29 subsets) were included in the present meta-analysis. Pooled sensitivity of CT was 0.786 [95% confidence interval (CI), 0.574–0.909], and pooled specificity was 0.944 (95% CI, 0.900–0.970). Pooled sensitivity of the 1–4 detector row group and 16–64 detector row group was 0.487 (95% CI, 0.215–0.767) and 0.915 (95% CI, 0.848–0.953), respectively. Pooled specificity of the 1–4 and 16–64 detector row groups was 0.956 (95% CI, 0.876–0.985) and 0.906 (95% CI, 0.828–0.951), respectively. Conclusion: Multi-detector CT with 16 or more detector rows has acceptable high sensitivity and specificity. Extravasation on CT indicates severe hemorrhage in patients with pelvic trauma. View Full-Text
Keywords: trauma; computed tomography; hemorrhage; angiography; pelvis trauma; computed tomography; hemorrhage; angiography; pelvis
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MDPI and ACS Style

Moon, S.N.; Pyo, J.-S.; Kang, W.S. Accuracy of Contrast Extravasation on Computed Tomography for Diagnosing Severe Pelvic Hemorrhage in Pelvic Trauma Patients: A Meta-Analysis. Medicina 2021, 57, 63. https://doi.org/10.3390/medicina57010063

AMA Style

Moon SN, Pyo J-S, Kang WS. Accuracy of Contrast Extravasation on Computed Tomography for Diagnosing Severe Pelvic Hemorrhage in Pelvic Trauma Patients: A Meta-Analysis. Medicina. 2021; 57(1):63. https://doi.org/10.3390/medicina57010063

Chicago/Turabian Style

Moon, Sung N., Jung-Soo Pyo, and Wu S. Kang. 2021. "Accuracy of Contrast Extravasation on Computed Tomography for Diagnosing Severe Pelvic Hemorrhage in Pelvic Trauma Patients: A Meta-Analysis" Medicina 57, no. 1: 63. https://doi.org/10.3390/medicina57010063

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