FAST Reappraisal: Cross-sectional Study

ABSTRACT

PURPOSE: Focused Assessment with Sonography for Trauma (FAST) provides an important initial screening examination in adult trauma patients. However, due to its low sensitivity, FAST is not a replacement for computed tomography (CT) in hemodynamically stable trauma patients. The aim of this study was to determine the test characteristics of FAST in adult, hemodynamically stable, blunt abdominal trauma patients by using a critical action as a reference standard. METHODS: The medical records for FAST examination at a single hospital from January 2009 to February 2011 were retrospectively reviewed. The inclusion criterion was isolated, hemodynamically stable, blunt abdominal trauma. Hemodynamically unstable patients or patients with penetrating injuries were excluded. The reference standard was the presence of a critical action, which was defined as one of the following 1) operative intervention for a finding discovered on CT, 2) interventional radiology for bleeding, 3) transfusion of 2 or more packed RBCs, or 4) death at the emergency department. RESULTS: There were 230 patients who met the inclusion criterion. There were 20 true positive, 206 true negative, 0 false positive, and 4 false negative results. The sensitivity and the specificity were 83% and 100%, respectively. CONCLUSION: Despite its low sensitivity for detecting any abnormal finding discovered on CT, negative FAST could aid to exclude critical action in hemodynamically stable, blunt abdominal trauma patients.