False-Negative FAST Examination: Associations With Injury Characteristics and Patient Outcomes

Laselle, Brooks; Byyny, Richard L.; Haukoos, Jason S.; Krzyzaniak, Sara; Brooks, Jessica; Dalton, Thomas R.; Gravitz, Craig; Kendall, John L.

doi:10.1016/j.annemergmed.2012.01.023

Cited by 29 publications

(29 citation statements)

References 37 publications

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“…Previous studies have investigated the accuracy of the FAST-exam [6, 7, 19–23, 25, 26], although only a limited number of these studies were conducted in HD stable patients [19, 21]. The low sensitivity of FAST as found in our study (67%) is comparable to sensitivities reported in these studies.…”

Section: Discussionsupporting

confidence: 68%

Should we perform a FAST exam in haemodynamically stable patients presenting after blunt abdominal injury: a retrospective cohort study

Dammers

Moumni

Hoogland

et al. 2017

Scand J Trauma Resusc Emerg Med

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BackgroundFocussed Assessment with Sonography for Trauma (FAST) is a bedside ultrasonography technique used to detect free intraperitoneal fluid in patients presenting with blunt abdominal trauma (BAT) in the emergency department.MethodsIn this retrospective cohort study we investigated the potential of FAST as a risk stratification instrument in haemodynamically (HD) stable patients presenting after BAT by establishing the association between the FAST exam result and final outcome. An adverse outcome was defined in this context as the need for either a laparoscopy/laparotomy or an angiographic embolization or death due to abdominal injuries).ResultsA total of 421 patients with BAT were included, of which nine had an adverse outcome (2%). FAST was negative in 407 patients. Six of them turned out to have free intraperitoneal fluid (sensitivity 67 [41–86]%). FAST was positive in 14 patients, 12 of whom had free intraperitoneal fluid (specificity 99 [98–100]%). A positive FAST (positive likelihood ratio 34.3 [15.1–78.5]) was stronger associated with an adverse outcome than Injury Severity Score (ISS) or any individual clinical- or biochemical variables measured at presentation in the ED.DiscussionThe FAST exam can provide valuable prognostic information at minimal expenses during the early stages of resuscitation in haemodynamically stable patients presenting with BAT.ConclusionsFAST exam should not be omitted in patients with BAT.Electronic supplementary materialThe online version of this article (doi:10.1186/s13049-016-0342-0) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 68%

Should we perform a FAST exam in haemodynamically stable patients presenting after blunt abdominal injury: a retrospective cohort study

Dammers

Moumni

Hoogland

et al. 2017

Scand J Trauma Resusc Emerg Med

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“…FAST has limitations; it has been argued that FAST results in the underdiagnosis of intra-abdominal injury,7 although a retrospective study of 332 patients found a false-negative result is rarely associated with poor patient outcomes 8. A study of 226 patients found in solid organ injury false negatives are more likely to occur in low-grade injuries (grade I or II) 9.…”

Section: Discussionmentioning

confidence: 99%

FAST in the deployed military setting

Carter

Gay

2018

J R Army Med Corps

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This study demonstrates that FAST is accurate on operations. FAST is provided by the integrated radiologist as part of damage control radiology, which gives the team leader rapid diagnostic information to improve decision-making and ultimately patient outcomes. CT is heavily utilised in civilian practice; however, the military operates in a different environment often with multiple casualties and limited access to CT, as a result, portable ultrasound will continue to be a valuable tool on operations if used properly. The next challenge is to develop and maintain this high diagnostic accuracy in future deployments where the memories of our prior success may fade.

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“…Laselle and colleagues 51 provide an excellent overview of false-negative FAST scans. These investigators studied 332 patients with a median injury severity score of 27.…”

Section: False-negative Fastmentioning

confidence: 98%