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European Journal of Orthopaedic Surgery & Traumatology

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Open Access 22-01-2024 | Laparotomy | Original Article

Accuracy of FAST in detecting intraabdominal bleeding in major trauma with pelvic and/or acetabular fractures: a retrospective cohort study

Authors: Lasse Rehné Jensen, Emma Possfelt-Møller, Allan Evald Nielsen, Upender Martin Singh, Lars Bo Svendsen, Luit Penninga

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 3/2024

Abstract

Purpose

The Focused Assessment with Sonography for Trauma (FAST) is a tool to rapidly detect intraabdominal and intrapericardial fluid with point-of-care ultrasound. Previous studies have questioned the role of FAST in patients with pelvic fractures. The aim of the present study was to assess the accuracy of FAST to detect clinically significant intraabdominal hemorrhage in patients with pelvic fractures.

Methods

We included all consecutive patients with pelvic and/or acetabular fractures treated our Level 1 trauma center from 2009–2020. We registered patient and fracture characteristics, FAST investigations and CT descriptions, explorative laparotomy findings, and transfusion needs. We compared FAST to CT and laparotomy findings, and calculated true positive and negative findings, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV).

Results

We included 389 patients. FAST had a sensitivity of 75%, a specificity of 98%, a PPV of 84%, and a NPV of 96% for clinically significant intraabdominal bleeding. Patients with retroperitoneal hematomas were at increased risk for laparotomy both because of True-negative FAST and False-positive FAST.

Conclusion

FAST is accurate to identify clinically significant intraabdominal blood in patients with severe pelvic fractures and should be a standard asset in these patients. Retroperitoneal hematomas challenge the FAST interpretation and thus the decision making when applying FAST in patients with pelvic fractures.

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Title: Accuracy of FAST in detecting intraabdominal bleeding in major trauma with pelvic and/or acetabular fractures: a retrospective cohort study
Authors: Lasse Rehné Jensen
Emma Possfelt-Møller
Allan Evald Nielsen
Upender Martin Singh
Lars Bo Svendsen
Luit Penninga
Publication date: 22-01-2024
Publisher: Springer Paris
Keywords: Laparotomy
Laparotomy
Acetabular Fracture
Hematoma
Published in: European Journal of Orthopaedic Surgery & Traumatology / Issue 3/2024
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI: https://doi.org/10.1007/s00590-023-03813-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Accuracy of FAST in detecting intraabdominal bleeding in major trauma with pelvic and/or acetabular fractures: a retrospective cohort study

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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