Retrospective comparison of fast examinations by emergency physicians with abdominal CT and abdominal surgery results in abdominal trauma (blunt / penetrating)

OBJECTIVE: The most important factor of lowering the rate of mortality and morbidity in trauma patients is the evaluation of the trauma victim rapidly, and if there is a life-threatening situation present, initiation of the appropriate treatment. Major purpose of this clinical study is to evaluate the utility of FAST modality, which provides significant advantages of determination of traumatic intraabdominal injuries rapidly and thoroughly, by Emergency Physicians and to compare this significant part of the education of EM specialists, FAST with other diagnostic modalities. METHOD: 180 trauma patients of all ages have been enrolled who presented to Adnan Menderes University Hospital Emergency Clinic with blunt/penetrating abdominal trauma evaluated with FAST and abdominal CT simultaneously between September 2012 and September 2014. Patients' files have been examined retrospectively. Types of trauma, initial vital signs, physical examination, initial laboratory findings, FAST and CT findings and if performed DPL and surgical intervention findings were recorded on case report forms. Arterial blood pressure and pulse have been recorded as vital signs and hemoglobin, leukocyte, platelet counts, urea, creatinine, aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were recorded as laboratory findings. RESULTS: 39 of 180 patients enrolled (21,7%) were female and 141 of 180 patients (78,3%) were male. The median age of female patients was 39,28±23,221 and of male patients was 40,21±18,358 respectively. In our study, sensitivity was 20,83% and the specifity was 98,71%. PPV was found 71,42% and NPV was found 89,01% respectively. The accuracy of test was 88,33%. CONCLUSION: Consequently, FAST should be performed by Emergency Physicians because of its accuracy in abdominal injuries with significant intrabdominal bleeding and also it is rapid, suitable for patient comfort and applicable by bedside. Also we strongly recommend an additional imaging modality or sequential FAST examinations in FAST negative patients. Keywords: Emergency Physicians, Blunt/Penetrating Abdominal Trauma, FAST, Sonography