Abstract

Intensive care unit (ICU) admission rate after abdominal trauma is affected by the mechanism of injury, early physiology, diagnostic accuracy, and operative strategy. Clinical findings alone cannot exclude blunt intra-abdominal injury; focused assessment with sonography for trauma (FAST) has limited sensitivity, and contrast-enhanced ultrasound improves detection. To compare predictors of ICU admission and ED-linked outcomes in blunt and penetrating abdominal trauma. A PRISMA-guided systematic review was conducted of original studies in ED patients with blunt or penetrating abdominal trauma. The primary outcome was ICU admission. Secondary outcomes included mortality, urgent laparotomy control surgery, transfusion, complications, and ICU length of stay. Databases searched include (PubMed, WOS, and Scopus). Two reviewers independently screened, extracted data, and assessed the risk of bias. Total 9 studies were included, most were retrospective cohorts or registry-based analyses conducted in Canada, the Netherlands, Turkiye, Iran, Saudi Arabia, Korea, Thailand, and Yemen. Sample sizes ranged from 40 to 3,888 participants. Study populations included blunt abdominal trauma, penetrating abdominal trauma, or mixed mechanisms. It was found that hemodynamic instability, higher injury severity, positive FAST findings, and emergent operative intervention predicted ICU admission and outcomes. ICU triage after abdominal trauma should be guided by early physiology, injury severity, imaging findings, and the need for urgent operative control. Isolated clinical assessment cannot safely exclude blunt intra-abdominal injury, and FAST is valuable for rapid rule-in decisions.

Key words: Abdominal trauma, blunt injury, penetrating injury, intensive care unit admission, emergency department triage, predictors, FAST, damage control surgery.