Predictive value of a false-negative focused abdominal sonography for trauma (FAST) result in patients with confirmed traumatic abdominal injury
Abstract Objective To investigate if patients with confirmed traumatic abdominal injury and a false-negative focused abdominal sonography for trauma (FAST) examination have a more favorable prognosis than those with a true-positive FAST. Methods This study included 97 consecutive patients with confi...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2020-09-01
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| Series: | Insights into Imaging |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13244-020-00911-5 |
| _version_ | 1818261375770689536 |
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| author | Mohammed H. A. Alramdan Derya Yakar Frank F. A. IJpma Ömer Kasalak Thomas C. Kwee |
| author_facet | Mohammed H. A. Alramdan Derya Yakar Frank F. A. IJpma Ömer Kasalak Thomas C. Kwee |
| author_sort | Mohammed H. A. Alramdan |
| collection | DOAJ |
| description | Abstract Objective To investigate if patients with confirmed traumatic abdominal injury and a false-negative focused abdominal sonography for trauma (FAST) examination have a more favorable prognosis than those with a true-positive FAST. Methods This study included 97 consecutive patients with confirmed traumatic abdominal injury (based on computed tomography [CT] and/or surgical findings) who underwent FAST. Results FAST was false-negative in 40 patients (41.2%) and true-positive in 57 patients (58.8%). Twenty-two patients (22.7%) had an unfavorable outcome (defined as the need for an interventional radiologic procedure, laparotomy, or death due to abdominal injury). Univariately, a false-negative FAST (odds ratio [OR] 0.24; p = 0.017) and a higher systolic blood pressure (OR, 0.97 per mmHg increase; p = 0.034) were significantly associated with a favorable outcome, whereas contrast extravasation on CT (OR, 7.17; p = 0.001) and shock index classification (OR, 1.89 for each higher class; p = 0.046) were significantly associated with an unfavorable outcome. Multivariately, only contrast extravasation on CT remained significantly associated with an unfavorable outcome (OR, 4.64; p = 0.016). When excluding contrast extravasation on CT from multivariate analysis, only a false-negative FAST result was predictive of a favorable outcome (OR, 0.28; p = 0.038). Conclusion Trauma patients with confirmed abdominal injury and a false-negative FAST have a better outcome than those with a positive FAST. FAST may be valuable for risk stratification and prognostication in patients with a high suspicion of abdominal injury when CT has not been performed yet or when CT is not available. |
| first_indexed | 2024-12-12T18:46:14Z |
| format | Article |
| id | doaj.art-73e53c6ca6ca44ec95d8ee024fab1b6c |
| institution | Directory Open Access Journal |
| issn | 1869-4101 |
| language | English |
| last_indexed | 2024-12-12T18:46:14Z |
| publishDate | 2020-09-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Insights into Imaging |
| spelling | doaj.art-73e53c6ca6ca44ec95d8ee024fab1b6c2022-12-22T00:15:31ZengSpringerOpenInsights into Imaging1869-41012020-09-011111910.1186/s13244-020-00911-5Predictive value of a false-negative focused abdominal sonography for trauma (FAST) result in patients with confirmed traumatic abdominal injuryMohammed H. A. Alramdan0Derya Yakar1Frank F. A. IJpma2Ömer Kasalak3Thomas C. Kwee4Medical Imaging Center, Department of Radiology, Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center GroningenMedical Imaging Center, Department of Radiology, Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center GroningenDepartment of Trauma Surgery, University of Groningen, University Medical Center GroningenMedical Imaging Center, Department of Radiology, Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center GroningenMedical Imaging Center, Department of Radiology, Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center GroningenAbstract Objective To investigate if patients with confirmed traumatic abdominal injury and a false-negative focused abdominal sonography for trauma (FAST) examination have a more favorable prognosis than those with a true-positive FAST. Methods This study included 97 consecutive patients with confirmed traumatic abdominal injury (based on computed tomography [CT] and/or surgical findings) who underwent FAST. Results FAST was false-negative in 40 patients (41.2%) and true-positive in 57 patients (58.8%). Twenty-two patients (22.7%) had an unfavorable outcome (defined as the need for an interventional radiologic procedure, laparotomy, or death due to abdominal injury). Univariately, a false-negative FAST (odds ratio [OR] 0.24; p = 0.017) and a higher systolic blood pressure (OR, 0.97 per mmHg increase; p = 0.034) were significantly associated with a favorable outcome, whereas contrast extravasation on CT (OR, 7.17; p = 0.001) and shock index classification (OR, 1.89 for each higher class; p = 0.046) were significantly associated with an unfavorable outcome. Multivariately, only contrast extravasation on CT remained significantly associated with an unfavorable outcome (OR, 4.64; p = 0.016). When excluding contrast extravasation on CT from multivariate analysis, only a false-negative FAST result was predictive of a favorable outcome (OR, 0.28; p = 0.038). Conclusion Trauma patients with confirmed abdominal injury and a false-negative FAST have a better outcome than those with a positive FAST. FAST may be valuable for risk stratification and prognostication in patients with a high suspicion of abdominal injury when CT has not been performed yet or when CT is not available.http://link.springer.com/article/10.1186/s13244-020-00911-5AbdomenFAST examPatient outcome assessmentTraumaUltrasonography |
| spellingShingle | Mohammed H. A. Alramdan Derya Yakar Frank F. A. IJpma Ömer Kasalak Thomas C. Kwee Predictive value of a false-negative focused abdominal sonography for trauma (FAST) result in patients with confirmed traumatic abdominal injury Insights into Imaging Abdomen FAST exam Patient outcome assessment Trauma Ultrasonography |
| title | Predictive value of a false-negative focused abdominal sonography for trauma (FAST) result in patients with confirmed traumatic abdominal injury |
| title_full | Predictive value of a false-negative focused abdominal sonography for trauma (FAST) result in patients with confirmed traumatic abdominal injury |
| title_fullStr | Predictive value of a false-negative focused abdominal sonography for trauma (FAST) result in patients with confirmed traumatic abdominal injury |
| title_full_unstemmed | Predictive value of a false-negative focused abdominal sonography for trauma (FAST) result in patients with confirmed traumatic abdominal injury |
| title_short | Predictive value of a false-negative focused abdominal sonography for trauma (FAST) result in patients with confirmed traumatic abdominal injury |
| title_sort | predictive value of a false negative focused abdominal sonography for trauma fast result in patients with confirmed traumatic abdominal injury |
| topic | Abdomen FAST exam Patient outcome assessment Trauma Ultrasonography |
| url | http://link.springer.com/article/10.1186/s13244-020-00911-5 |
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