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Journal of the Korean Society of Traumatology 2012;25(3):67-71.
FAST Reappraisal: Cross-sectional Study
Sang Hyun Ha, Chong Kun Hong, Jun Ho Lee, Seong Youn Hwang, Seong Hee Choi
1Department of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea. schsfc@hanmail.net
2Department of Surgery, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.
혈역학적으로 안정된 복부둔상환자에서 FAST의 유용성 평가
하상현1∙홍종근1∙이준호1∙황성연1∙최성희2
성균관대학교 삼성창원병원 응급의학과1,
성균관대학교 삼성창원병원 외과2
Received: 30 April 2012   • Revised: 19 July 2012   • Accepted: 31 August 2012
Abstract
PURPOSE
Focused Assessment with Sonography for Trauma (FAST) provides an important initial screening examination in adult trauma patients. However, due to its low sensitivity, FAST is not a replacement for computed tomography (CT) in hemodynamically stable trauma patients. The aim of this study was to determine the test characteristics of FAST in adult, hemodynamically stable, blunt abdominal trauma patients by using a critical action as a reference standard.
METHODS
The medical records for FAST examination at a single hospital from January 2009 to February 2011 were retrospectively reviewed. The inclusion criterion was isolated, hemodynamically stable, blunt abdominal trauma. Hemodynamically unstable patients or patients with penetrating injuries were excluded. The reference standard was the presence of a critical action, which was defined as one of the following: 1) operative intervention for a finding discovered on CT, 2) interventional radiology for bleeding, 3) transfusion of 2 or more packed RBCs, or 4) death at the emergency department.
RESULTS
There were 230 patients who met the inclusion criterion. There were 20 true positive, 206 true negative, 0 false positive, and 4 false negative results. The sensitivity and the specificity were 83% and 100%, respectively.
CONCLUSION
Despite its low sensitivity for detecting any abnormal finding discovered on CT, negative FAST could aid to exclude critical action in hemodynamically stable, blunt abdominal trauma patients.
Key Words: Abdominal injury; Ultrasonography; Blunt injury
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