Investigating the Diagnostic Accuracy of Focused Assessment with Sonography in Trauma (FAST) Compared to CT Scan in Patients with Blunt Abdominal Trauma

The use of Focused Assessment with Sonography in Trauma (FAST) in blunt abdominal trauma has various advantages and disadvantages. Considering the importance of timely diagnosis of blunt abdominal traumas, the question is whether it is possible to manage these patients only by performing FAST in the emergency room? Therefore, this study was conducted with the aim of comparing the diagnostic accuracy of FAST with CT-Scan in patients with blunt abdominal trauma.

This cross-sectional study was conducted on 400 patients with blunt abdominal trauma referred to the emergency department of affiliated teaching hospitals of Kerman University of Medical Sciences in 2020. Data were obtained by examining the medical records of the patients. The results of FAST were compared with the results of abdominal and pelvic CT scan (as a gold standard), diagnostic peritoneal lavage (DPL) and laparotomy results (as a gold standard in case of unclear CT-Scan results) and the sensitivity, specificity, the positive and negative predictive value and its accuracy were determined.

The mean age of the participants was 36.27±10.44 years. 72.5% of them were men. The most common organ involved was the liver (73%). Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of FAST were equal to 75.1 (73.4-79.6), 91.7 (89.4-94.7), 94.1 (92.7-96.3), 77.2 (75.7-79.6) and 83.7 (80.3-85.5), respectively. Also, the odds ratio of FAST in detecting free fluid was 1335.3, injury to intra-abdominal organs was 7.53 and it was 28.9 for all cases.

The results of the study showed that FAST sonography in the emergency room is a suitable method for diagnosing free intra-abdominal fluid following blunt trauma, but it cannot properly diagnose the location of the injury.