{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:53:32Z","timestamp":1791852812178,"version":"4.3.4"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"vor","delay-in-days":92,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Operative triage of abdominal trauma, whether blunt or penetrating, remains a major challenge in emergency care. Although quantitative decision-support tools, such as Pediatric Emergency Care Applied Research Network (PECARN) rule, Focused Assessment with Sonography in Trauma (FAST), Shock Index, Pediatric Age-Adjusted (SIPA), and Blunt Abdominal Trauma Scoring System (BATSS), are widely used, they do not fully capture the complex clinical reasoning and experiential judgment required for real-world decision-making. This limitation is particularly important because blunt and penetrating abdominal trauma differ substantially in their pathophysiology, injury patterns, and management priorities. This qualitative study explored the patient-related factors influencing surgical prioritization (operative triage) of abdominal trauma from the perspectives of clinicians involved in trauma care. This qualitative study used a conventional content analysis approach. Ten clinicians with direct experience in abdominal trauma triage were purposively recruited from teaching hospitals affiliated with Dezful University of Medical Sciences, Iran. Participants included five specialist physicians (two anesthesiologists, one general surgeon, and two emergency medicine physicians) and five nursing and allied health professionals (two nurses with PhDs in Nursing, one nurse with a Master\u2019s degree, one surgical technologist with a Master\u2019s degree, and one Master\u2019s-level anesthesia professional). Data were collected through ten in-depth, semi-structured interviews and analyzed manually using the five-step content analysis method proposed by Graneheim and Lundman. Trustworthiness was established according to Lincoln and Guba\u2019s criteria. Analysis identified three main categories and ten subcategories influencing operative triage of abdominal trauma: physiological status (vital signs, respiratory distress, indicators of shock, level of consciousness, and associated neurological injury), individual and contextual characteristics (age, pregnancy, and comorbidities), and injury severity and pattern (limb injuries, extra-abdominal trauma, and head injury). Clinicians consistently distinguished between blunt and penetrating abdominal trauma during surgical prioritization. In blunt trauma, concealed hemorrhage, hemodynamic instability, and imaging findings suggestive of solid organ injury were the primary determinants of urgency. In penetrating trauma, injury trajectory, peritoneal violation, and the need for immediate surgical exploration were prioritized. Participants described operative triage as a dynamic process that integrates multiple clinical cues, contextual information, and professional experience rather than relying solely on algorithm-based protocols. Operative triage of abdominal trauma is a multidimensional clinical decision-making process that extends beyond standardized scoring systems and fixed numerical thresholds. Surgical prioritization requires the simultaneous integration of injury mechanism, physiological status, patient characteristics, and contextual clinical information. These findings underscore the importance of combining evidence-based protocols with experienced clinical judgment, particularly when managing patients with multisystem trauma, complex injuries, or atypical presentations. Incorporating these factors into trauma education, clinical training, and future decision-support systems may improve the accuracy, consistency, and timeliness of operative triage for patients with abdominal trauma.<\/jats:p>","DOI":"10.1038\/s41598-026-61494-7","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T03:25:13Z","timestamp":1783913113000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A conventional content analysis of clinicians\u2019 perspectives on patient-based factors that influence surgical prioritization of abdominal trauma"],"prefix":"10.1038","volume":"16","author":[{"given":"Leila","family":"Kalani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hooman","family":"Etedali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neda","family":"Rashidi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armin","family":"Zareiyan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farhad","family":"Nanaei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marzieh Beigom","family":"Bigdeli Shamloo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"issue":"50","key":"61494_CR1","first-page":"892","volume":"107","author":"M Christ","year":"2010","unstructured":"Christ, M., Grossmann, F., Winter, D., Bingisser, R. & Platz, E. 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Permission was also obtained from the authorities of the emergency department and operating room at the same hospital. Comprehensive explanations of the study\u2019s objectives and procedures were given to the individuals approached for participation. Participants were free to take part or to withdraw from the study at any stage. Written informed consent was obtained from all participants prior to their involvement. They were assured that the information obtained from them and the research results would remain confidential. They were informed that they could withdraw at any time without any consequences and that no costs would be imposed on them. Participants were also told that, if they wished, the research results would be made available to them. The principles of honesty and integrity were upheld in the use of all sources and publications. The study was approved by the Ethics Committee of the Research Deputy of Dezful University of Medical Sciences (ethical code: IR.DUMS.REC.1402.038). All participants provided written consent via a written consent form.","order":2,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":3,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors acknowledge the use of DeepSeek AI as an artificial intelligence\u2013assisted language tool during the preparation and revision of this manuscript. DeepSeek AI was used to support academic language editing, enhance the fluency and native quality of the English translation, and assist in drafting structured, evidence-based responses to reviewers\u2019 comments during the peer-review process. All AI-generated outputs were carefully reviewed, verified, and substantially revised by the authors. The authors take full responsibility for the accuracy, integrity, and final content of the manuscript.","order":4,"name":"Ethics","label":"AI declaration","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"31985"}}