The predictive value of skin lesions for intrathoracic and intra-abdominal injuries in patients with blunt thoracic and abdominal trauma.

AIM: To assess whether thoracic and abdominal skin lesions predict CT-detected intrathoracic and intra-abdominal injuries in adults with blunt torso trauma.

METHODS: This single-center retrospective study included 1523 adults (June 2014-June 2024) with blunt thoracic and/or abdominal trauma who underwent both chest CT and contrast-enhanced abdominal CT. Skin lesions and their anatomical locations were extracted from forensic examination forms. Outcomes were any pathological finding on chest CT and abdominal CT. Associations were evaluated using logistic regression, and discrimination was assessed using ROC curves (AUC).

RESULTS: Median age was 42 (IQR 27-59) years, and 69.7% were male. Traffic accidents were the most common mechanism (45.9%). Chest CT pathology was present in 24.8% and abdominal CT pathology in 10.6%. Any thoracic skin lesion was associated with higher odds of chest CT pathology (52.6% vs 19.7%; OR 4.52, 95% CI 3.38-6.04; AUC 0.615). Any abdominal skin lesion was associated with higher odds of abdominal CT pathology (33.9% vs 7.6%; OR 6.22, 95% CI 4.28-9.06; AUC 0.639). Region-specific lesion models showed limited discrimination (AUC ∼0.50-0.55).

CONCLUSION: Skin lesions are strongly associated with CT-detected intrathoracic and intra-abdominal injuries in blunt torso trauma, but their standalone discriminative performance is limited; they should be interpreted as supportive risk markers rather than definitive screening criteria.