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BMC Medical Imaging
Published in: BMC Medical Imaging 1/2009

Open Access 01-12-2009 | Research article

The accuracy of FAST in relation to grade of solid organ injuries: A retrospective analysis of 226 trauma patients with liver or splenic lesion

Authors: Beat Schnüriger, Joachim Kilz, Daniel Inderbitzin, Miranda Schafer, Ralph Kickuth, Martin Luginbühl, Daniel Candinas, Aristomenis K Exadaktylos, Heinz Zimmermann

Published in: BMC Medical Imaging | Issue 1/2009

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Abstract

Background

This study investigated the role of a negative FAST in the diagnostic and therapeutic algorithm of multiply injured patients with liver or splenic lesions.

Methods

A retrospective analysis of 226 multiply injured patients with liver or splenic lesions treated at Bern University Hospital, Switzerland.

Results

FAST failed to detect free fluid or organ lesions in 45 of 226 patients with spleen or liver injuries (sensitivity 80.1%). Overall specificity was 99.5%. The positive and negative predictive values were 99.4% and 83.3%. The overall likelihood ratios for a positive and negative FAST were 160.2 and 0.2. Grade III-V organ lesions were detected more frequently than grade I and II lesions. Without the additional diagnostic accuracy of a CT scan, the mean ISS of the FAST-false-negative patients would be significantly underestimated and 7 previously unsuspected intra-abdominal injuries would have been missed.

Conclusion

FAST is an expedient tool for the primary assessment of polytraumatized patients to rule out high grade intra-abdominal injuries. However, the low overall diagnostic sensitivity of FAST may lead to underestimated injury patterns and delayed complications may occur. Hence, in hemodynamically stable patients with abdominal trauma, an early CT scan should be considered and one must be aware of the potential shortcomings of a "negative FAST".
Appendix
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Metadata
Title
The accuracy of FAST in relation to grade of solid organ injuries: A retrospective analysis of 226 trauma patients with liver or splenic lesion
Authors
Beat Schnüriger
Joachim Kilz
Daniel Inderbitzin
Miranda Schafer
Ralph Kickuth
Martin Luginbühl
Daniel Candinas
Aristomenis K Exadaktylos
Heinz Zimmermann
Publication date
01-12-2009
Publisher
BioMed Central
Published in
BMC Medical Imaging / Issue 1/2009
Electronic ISSN: 1471-2342
DOI
https://doi.org/10.1186/1471-2342-9-3

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