Diagnostic Accuracy of FAST Scan in Hemodynamically Stable Blunt Abdominal Injury Patients; Is it "Fast" enough?

Abstract

Objective: To determine the diagnostic accuracy of a Focused Assessment with Sonography for Injury (FAST) scan in blunt abdominal injury with suspected hollow viscus organ perforation, keeping a computed tomography (CT) scan of the abdomen as a reference. Study Design: Cross-sectional study. Place and Duration of Study: Radiology Department, Combined Military Hospital, Peshawar Pakistan, from Aug 2017 to Feb 2018. Methodology: One hundred forty-seven hemodynamically stable patients aged 20-60 years of either gender presenting in the Emergency Department (ED) with clinical suspicion of blunt abdominal injury were included. FAST scan and CT abdomen reporting were done by two separate consultants blinded to each other. Results: The mean age was 35.84±8.44 years, ranging from 21-60 years. Among 72 FAST-positive patients, 68(46.3%) were true positive, and 4(2.7%) were false positive. Among 75 FAST negative patients, 6(4.1%) were false negative, and 69(46.9%) were true negative. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of FAST compared to CT was 91.89%, 94.52%, 94.44% and 92.00%, respectively; FAST scan was correct in 93.20%. Conclusions: FAST Ultrasound is a sensitive and specific tool in the screening and diagnosing of abdominal injury resulting from blunt abdominal injury.