FAST as a predictor of clinical outcome in blunt abdominal trauma
Background. Peer-reviewed literature demonstrates increasing support for the use of focused abdominal sonography in trauma (FAST) in the setting of blunt trauma, one study demonstrating the sensitivity and specificity of FAST for the detection of free fluid to be 0.64 - 0.98 and 0.86 - 1.00, respect...
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| Format: | Article |
| Language: | English |
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AOSIS
2011-12-01
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| Series: | South African Journal of Radiology |
| Subjects: | |
| Online Access: | https://sajr.org.za/index.php/sajr/article/view/352 |
| _version_ | 1819297351464910848 |
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| author | Benjamin M Terry David Blehar Romolo Gaspari Arthur Thomas Maydell Fourie Abraham Bezuidenhout Savvas Andronikou |
| author_facet | Benjamin M Terry David Blehar Romolo Gaspari Arthur Thomas Maydell Fourie Abraham Bezuidenhout Savvas Andronikou |
| author_sort | Benjamin M Terry |
| collection | DOAJ |
| description | Background. Peer-reviewed literature demonstrates increasing support for the use of focused abdominal sonography in trauma (FAST) in the setting of blunt trauma, one study demonstrating the sensitivity and specificity of FAST for the detection of free fluid to be 0.64 - 0.98 and 0.86 - 1.00, respectively, compared with abdominal CT. Utilising ultrasound in trauma triage increases efficiency and cost-effectiveness and reduces reliance on CT, compared with using CT alone. There is little evidence to support relying solely on a negative FAST and physical examination for patient management.
Method. A retrospective descriptive study of 172 adult patients who received FAST for the evaluation of blunt abdominal trauma between 22 July 2007 and 21 January 2008 at Tygerberg Hospital was performed. Ultrasound findings were correlated with CT scan findings, operative findings if managed surgically, clinical outcomes whether managed surgically or conservatively, as well as postmortem findings in deceased patients.
Results. FAST was negative in 147 (85.5%) patients. Twenty-four (16.3%) of these patients died from all-cause mortality, none of which was due to intra-abdominal injury.
Seven patients with negative FAST underwent CT scan owing to change in clinical course, and 3 patients with negative FAST underwent laparotomy owing to change in clinical course, with positive findings in 2 patients – a bowel injury requiring resection (not seen on CT) and a diaphragmatic rupture seen on CXR. A negative FAST was shown to be an excellent predictor for the absence of significant intra-abdominal trauma.
The mortality rate among 25 FAST positive patients was 24% (N=6). Only one of these patients (with a splenic rupture) was suspected to have died from abdominal pathology. |
| first_indexed | 2024-12-24T05:12:37Z |
| format | Article |
| id | doaj.art-d644b282af994c92a150d9281192e5a9 |
| institution | Directory Open Access Journal |
| issn | 1027-202X 2078-6778 |
| language | English |
| last_indexed | 2024-12-24T05:12:37Z |
| publishDate | 2011-12-01 |
| publisher | AOSIS |
| record_format | Article |
| series | South African Journal of Radiology |
| spelling | doaj.art-d644b282af994c92a150d9281192e5a92022-12-21T17:13:38ZengAOSISSouth African Journal of Radiology1027-202X2078-67782011-12-0115410.4102/sajr.v15i4.352352FAST as a predictor of clinical outcome in blunt abdominal traumaBenjamin M Terry0David Blehar1Romolo Gaspari2Arthur Thomas Maydell3Fourie Abraham Bezuidenhout4Savvas Andronikou5University of MassachusettsUniversity of MassachusettsUniversity of MassachusettsStellenbosch UniversityStellenbosch UniversityUniversity of Cape TownBackground. Peer-reviewed literature demonstrates increasing support for the use of focused abdominal sonography in trauma (FAST) in the setting of blunt trauma, one study demonstrating the sensitivity and specificity of FAST for the detection of free fluid to be 0.64 - 0.98 and 0.86 - 1.00, respectively, compared with abdominal CT. Utilising ultrasound in trauma triage increases efficiency and cost-effectiveness and reduces reliance on CT, compared with using CT alone. There is little evidence to support relying solely on a negative FAST and physical examination for patient management. Method. A retrospective descriptive study of 172 adult patients who received FAST for the evaluation of blunt abdominal trauma between 22 July 2007 and 21 January 2008 at Tygerberg Hospital was performed. Ultrasound findings were correlated with CT scan findings, operative findings if managed surgically, clinical outcomes whether managed surgically or conservatively, as well as postmortem findings in deceased patients. Results. FAST was negative in 147 (85.5%) patients. Twenty-four (16.3%) of these patients died from all-cause mortality, none of which was due to intra-abdominal injury. Seven patients with negative FAST underwent CT scan owing to change in clinical course, and 3 patients with negative FAST underwent laparotomy owing to change in clinical course, with positive findings in 2 patients – a bowel injury requiring resection (not seen on CT) and a diaphragmatic rupture seen on CXR. A negative FAST was shown to be an excellent predictor for the absence of significant intra-abdominal trauma. The mortality rate among 25 FAST positive patients was 24% (N=6). Only one of these patients (with a splenic rupture) was suspected to have died from abdominal pathology.https://sajr.org.za/index.php/sajr/article/view/352Blunt abdominal trauma, focussed abdominal sonography in trauma |
| spellingShingle | Benjamin M Terry David Blehar Romolo Gaspari Arthur Thomas Maydell Fourie Abraham Bezuidenhout Savvas Andronikou FAST as a predictor of clinical outcome in blunt abdominal trauma South African Journal of Radiology Blunt abdominal trauma, focussed abdominal sonography in trauma |
| title | FAST as a predictor of clinical outcome in blunt abdominal trauma |
| title_full | FAST as a predictor of clinical outcome in blunt abdominal trauma |
| title_fullStr | FAST as a predictor of clinical outcome in blunt abdominal trauma |
| title_full_unstemmed | FAST as a predictor of clinical outcome in blunt abdominal trauma |
| title_short | FAST as a predictor of clinical outcome in blunt abdominal trauma |
| title_sort | fast as a predictor of clinical outcome in blunt abdominal trauma |
| topic | Blunt abdominal trauma, focussed abdominal sonography in trauma |
| url | https://sajr.org.za/index.php/sajr/article/view/352 |
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