Journal of Health and Medical Sciences
Published: 05 February 2020
Comparison of Diagnostic Accuracy of Focused Assessment with Sonography for Trauma (FAST) vs Computed Tomography for the Diagnosis of Blunt Torso Trauma
Maria Akram, Aiman Shehzad, Shabana Bibi, Hareem Zehra, Zainab Sajjad, Iqra Manzoor,
Ghulam Rasool, Rahma Bacha, Syed Yousaf Gilani, Faizan Nadeem, Mehreen Fatima
The University of Lahore, Lahore, Pakistan
Download Full-Text Pdf
Keywords: Blunt Torso Trauma, Focused Assessment for Sonography with Trauma (FAST), Computed Tomography (CT)
Background: FAST and CT scan are both widely used imaging techniques for diagnosing blunt torso trauma and have their limitaions and advantages. Objective: To evaluate the Accuracy of Focused Assessment with Sonography for Trauma (FAST) vs Computed Tomography for diagnosing Blunt Torso Trauma. Methodology: A cross sectional research which was done in Lahore in emergency department of Mayo hospital and Services hospital. Total 125 participants took part in the study who were victims of blunt torso trauma by road traffic accidents damaging mainly spleen, kidneys, liver, retroperitoneum, bladder and pancreas. FAST scan using Toshiba, Nemio model, Convex probe having a frequency of 3.75 MHz was carried out. Pictures were capture with different abdominal views. CT scan using Toshiba, 16 slice Hitachi and Scenaria, 128 slices was also done on the same population after giving contrast material. Results: Mean age of population under study was 37.87±11.678. FAST scan was administered on all patients and then CT scan was administered. Out of 125 scans 77 FAST positive scans were confirmed and 48 negative scans were confirmed by using CT scan. The values of sensitivity, specificity, ppv and npv of FAST scan were calculated to be 100%, 91.67, 100% and 85.42%. Conclusion: Although FAST is also a very valuable tool, some of the critical injuries that need immediate attention for the patient's life may be overlooked so CT scan is considered the best option for diagnostic accuracy of Blunt torso trauma.
- Kendall, J., Kestler, A., Whitaker, K., Adkisson, M.-M. and Haukoos, J. (2011). Blunt Abdominal Trauma Patients Are at Very Low Risk for Intra-Abdominal Injury after Emergency Department Observation. Western Journal of Emergency Medicine, 12(4), pp.496–504.
- Soto, J.A. and Anderson, S.W. (2012). Multidetector CT of Blunt Abdominal Trauma. Radiology, 265(3), pp.678–693.
- Fox, J.C., Boysen, M., Gharahbaghian, L., Cusick, S., Ahmed, S.S., Anderson, C.L., Lekawa, M. and Langdorf, M.I. (2011). Test Characteristics of Focused Assessment of Sonography for Trauma for Clinically Significant Abdominal Free Fluid in Pediatric Blunt Abdominal Trauma. Academic Emergency Medicine, 18(5), pp.477–482.
- Vicente, M.A., Mínguez, J., and González, D.C., (2017). The Use of Computed Tomography to Explore the Microstructure of Materials in Civil Engineering: From Rocks to Concrete. InTech.
- Kornezos, I., Chatziioannou, A., Kokkonouzis, I., Nebotakis, P., Moschouris, H., Yiarmenitis, S., Mourikis, D. and Matsaidonis, D. (2009). Findings and limitations of focused ultrasound as a possible screening test in stable adult patients with blunt abdominal trauma: a Greek study. European Radiology, 20(1), pp.234–238.
- Cunningham, A.J., Lofberg, K.M., Krishnaswami, S., Butler, M.W., Azarow, K.S., Hamilton, N.A., Fialkowski, E.A., Bilyeu, P., Ohm, E., Burns, E.C., Hendrickson, M., Krishnan, P., Gingalewski, C. and Jafri, M.A. (2017). Minimizing variance in Care of Pediatric Blunt Solid Organ Injury through Utilization of a hemodynamic-driven protocol: a multi-institution study. Journal of Pediatric Surgery, 52(12), pp.2026–2030.
- Guillen, B., Cassaro, S., (2018), Traumatic Open Abdomen: StatPearls [Internet], StatPearls Publishing, Treasure Island (FL), Oct 27, 2018.
- Sanjeev, S., Babita, G.N., (2017), Study on abdominal trauma patients comparatively by ultrasonography and CT. International Journal of Contemporary Medical Research, 4(4):872-873.
- Mushtaq, S., Khan, M.R., Akbar, A. and Bodla, M.A., (2014), Diagnostic Accuracy of Focused Abdominal Sonography in Trauma (FAST) in patients with blunt abdominal trauma. 8(2), 299-302
- Lateef, A., Khan, A.A., and Rana, M.M., (2019), Comparison of Efficacy of FAST and CT Scan in Patients with Blunt Abdominal Trauma. Annals of Punjab Medical College. 13(1)
- Boutros, S.M., Nassef, M.A. and Abdel-Ghany, A.F. (2016). Blunt abdominal trauma: The role of focused abdominal sonography in assessment of organ injury and reducing the need for CT. Alexandria Journal of Medicine, 52(1), pp.35–41.
- Tunuka, C.E., Wangoda, R., Bugeza, S. and Galukande, M. (2014). Emergency Sonography Aids Diagnostic Accuracy of Torso Injuries: A Study in a Resource Limited Setting. Emergency Medicine International, 2014, pp.1–6.
- Waheed, K., Baig, A., Raza, A., Ul Hassan, M., Khattab, M. and Raza, U. (2018). Diagnostic accuracy of Focused Assessment with Sonography for Trauma for blunt abdominal trauma in the Eastern Region of Saudi Arabia. Saudi Medical Journal, 39(6), pp.598–602.
- Ollerton, J.E., Sugrue, M., Balogh, Z., D’Amours S.K., Giles, A., Wyllie, P. (2016). Prospective study to evaluate the influence of FAST on trauma patient management. J Trauma, 60(4):785–91. doi: 10.1097/01.ta.0000214583.21492
- Mohammadi, A. and Ghasemi-rad, M. (2012). Evaluation of gastrointestinal injury in blunt abdominal trauma “FAST is not reliable”: the role of repeated ultrasonography. World Journal of Emergency Surgery, 7(1), p.2.
- Richards, J.R. and McGahan, J.P. (2017). Focused Assessment with Sonography in Trauma (FAST) in 2017: What Radiologists Can Learn. Radiology, 283(1), pp.30–48.
- Aboobakar, M.R., Singh, J.P., Maharaj, K., Mewa Kinoo, S. and Singh, B. (2017). Gastric perforation following blunt abdominal trauma. Trauma Case Reports, 10, pp.12–15.
- Lee, C., Balk, D., Schafer, J., Welwarth, J., Hardin, J., Yarza, S., Novack, V. and Hoffmann, B. (2019). Accuracy of Focused Assessment with Sonography for Trauma (FAST) in Disaster Settings: A Meta-Analysis and Systematic Review. Disaster Medicine and Public Health Preparedness, 13(5–6), pp.1059–1064.