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Reliability of RBC Count in Patients With Stab Wounds to the Chest

Erwin R. Thal, MD

Arch Surg. 1984;119(5):579-584.

Abstract
• Two hundred thirteen patients with stab wounds to the lower part of the chest and abdomen were reviewed to determine if a lavage RBC count of 100,000/cu mm was a reasonable figure to permit prompt recognition of injury and to minimize the number of negative operative procedures. There were four (1.9%) false-positive and nine (4.2%) false-negative lavages. Three patients (1.4%) had complications due to delayed operation, including one death (0.47%). Two patients (0.9%) had hollow viscus injuries; neither involved the colon. Three of the nine patients with injuries had cell counts of less than 1,000/cu mm. The negative celiotomy rate was 4.2%. It was concluded that the number of missed injuries, delayed operative procedures, and complications was sufficiently low enough to continue recommending 100,000 RBCs per cubic millimeter as a safe number to use as an indication for operation.

(Arch Surg 1984;119:579-584)

Author Affiliations
From the Department of Surgery, Southwestern Medical School, University of Texas Health Science Center, Dallas.

Footnotes
Accepted for publication Jan 16, 1984.

Read before the 91st annual meeting of the Western Surgical Association, Monterey, Calif, Nov 15, 1984.

Reprint requests to Department of Surgery, 5323 Harry Hines Blvd, Dallas, TX 75235 (Dr Thal).

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