Clinical utility of performing FAST scan in hemodynamically stable patients presenting with blunt abdominal trauma in level one trauma center

Abstract

Background: Focused assessment with sonography for trauma (FAST) has a role in the rapid screening of hemodynamically unstable patients to decide on management, however, its role in hemodynamically stable patients remains equivocal. Objectives: This study aimed to determine the sensitivity and specificity rate of FAST for intra-abdominal injury (IAI) in hemodynamically stable blunt abdominal trauma patients. Secondary outcomes like Glasgow coma score, length of hospital stays (LOS), head injury, and mortality were also examined for their association with FAST scan results. Settings and Design: A retrospective cross-sectional study was conducted in level-one trauma center in Bahrain. Methods: This study was conducted from January 2019 to October 2020. A total of 191 trauma codes were activated during this period, however, only 112 patients were included based on the inclusion criteria. Results: FAST scan in hemodynamically stable patients was found to have a higher specificity (96.7%) than sensitivity (30%) in this study. A higher negative predictive value (NPV) (86.4%) compared to a positive predictive value (66.6%) and a high accuracy rate (84.8%) was observed. LOS showed significant association only with FAST diagnostic accuracy. Conclusion: In hemodynamically stable patients; FAST is better at ruling in intra IAI when compared to ruling out and its high NPV supports it being a good screening tool. The results do not support the use of FAST as the sole diagnostic tool without performing computed tomography scan. [SJEMed 2023; 4(2.000): 120-127]

Keywords

• fast
• haemodynamically stable
• trauma
• blunt
• abdomen