Evaluation of the diagnostic value of FAST in patients with multiple trauma referring to a trauma center in northern Iran

Document Type : Original Article

Authors

Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran

Abstract

Background: Abdominal injuries are among the leading causes of death in trauma patients, with one-third developing abdominal trauma. Focused Assessment with Sonography in Trauma (FAST) is a crucial component of the initial evaluation for emergency care of patients with abdominal blunt trauma.
Objectives: This study aimed to investigate the accuracy of FAST in identifying occult abdominal injuries in trauma patients who underwent laparotomy surgery at our center.
Methods: This cross-sectional study included 180 patients with abdominal trauma admitted to Poursina Hospital in Rasht, Iran, from 2016 to 2017. All patients underwent FAST upon admission and were categorized as either positive or negative based on the findings. Those with a positive FAST underwent laparotomy, while those with a negative FAST underwent a CT scan.
Results: The sensitivity, specificity, positive predictive value, and negative predictive value of FAST compared to a CT scan in all patients were 60%, 52.4%, 23.3%, and 84.4%, respectively. Of the 90 patients with positive FAST, 78 underwent laparotomy, while 19 patients with negative FAST underwent laparotomy. Low blood pressure, Glasgow Coma Scale (GCS), and hospital arrival time were significantly associated with false-positive FAST results, while age was significantly related to false-negative cases.
Conclusion: While implementing FAST by surgical assistants has some limitations, its use can be complementary to other diagnostic methods like CT scans, especially when combined with proper training and consideration of patient factors.

Keywords


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