Too fast, or not fast enough? The FAST exam in patients with non-compressible torso hemorrhage - 16/04/19
, Ronald Chang b , Erin E. Fox b , Charles E. Wade b , John B. Holcomb b , Matthew J. Martin a, c the NCTH Study Group
Abstract |
Background |
Focused assessment with sonography for trauma (FAST) performance metrics are unknown in patients with non-compressible torso hemorrhage (NCTH).
Methods |
Retrospective review of a dedicated NCTH database from four level 1 trauma centers (2008–2012). NCTH was defined as (1) named axial torso vessel disruption; (2) AIS chest or abdomen >2 with shock (base deficit < -4) or truncal operation in ≤ 90 min; or (3) pelvic fracture with ring disruption. Patients were grouped by cavity of hemorrhage source and by shock (SBP ≤ 90).
Results |
274 patients had a FAST prior to diagnosis of NCTH. FAST was positive in 51% of patients with abdominal/pelvic hemorrhage for a false negative rate (FNR) of 49%. FNR was higher for pelvic (61%) versus abdominal (43%) sources (p = 0.02). There was no difference between FAST negative or positive patients for ISS, shock, length of stay, or mortality (all p = NS). FNR was not improved among the subgroup of NCTH patients with shock (p = NS).
Conclusion |
FAST identified abdominal/pelvic hemorrhage in approximately half of NCTH patients, and this was not improved among patients presenting with shock.
Le texte complet de cet article est disponible en PDF.Highlights |
• | FAST identified abdominal/pelvic hemorrhage in only half of NCTH patients. |
• | False negative rate was higher for pelvic (61%) versus abdominal (43%) sources. |
• | False negative rate was not improved among the subgroup of NCTH patients with shock. |
Keywords : Focused assessment with sonography for trauma, Non-compressible torso hemorrhage, False negative rate
Plan
| ☆ | Meeting Presentation: 105th Annual Meeting of the North Pacific Surgical Association, Boise, ID, November 9-10, 2018. |
Vol 217 - N° 5
P. 882-886 - mai 2019 Retour au numéro
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