title: Predictive factors for a FAST-positive and a therapeutic laparotomy in blunt abdominal injuries at the emergency room.
abstract: OBJECTIVE
  Identify the various factors that predict a Focused Assessment with Sonography for Trauma (FAST) positive result and a subsequent therapeutic laparotomy.
  
  
  METHODS
  The medical records of all patients, aged greater than fifteen-years-old, with blunt abdominal injuries that underwent a FAST examination in an emergency room at a university level I trauma center over a one-year period were reviewed retrospectively. Patient data (demographic, vital signs and revised trauma score) was analyzed to identify the factors that correlated with a FAST-positive result and the need to perform a therapeutic laparotomy.
  
  
  RESULTS
  Four hundred sixty five patients were eligible, of which twenty-eight patients had a FAST-positive result, and thirty-one patients underwent a therapeutic laparotomy. In multivariate analysis, the significant factors correlating with a FAST-positive result were an initial O2 saturation of 95% or less (OR = 4.0, 95% CI 1.4-11.5) and an abnormal abdominal examination (OR = 9.8, 95% CI 3.1-31.1). The factors correlating with a therapeutic laparotomy were a time of injury of one hour or less (OR = 11.2, 95% CI 1.1-116.8) and a FAST-positive result (OR = 11.1, 95% CI 1.1-113.6).
  
  
  CONCLUSIONS
  Patients with blunt abdominal injuries who present with decreased oxygen saturation and an abnormal abdominal examination have a high probability of FAST-positive result. Patients with the time of injury of less than one hour before reaching the emergency room, and a FAST-positive are important predictors of the need for therapeutic laparotomy.
authors.affiliation: Department of Emergency Medicine, Songklanagarind Hospital, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand. prasit0552002@yahoo.com
authors.forename: Prasit
authors.initials: P
authors.lastname: Wuthisuthimethawee
mesh_terms: D000007:Abdominal Injuries / Q000601:surgery*; D000328:Adult; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D014949:Wounds, Nonpenetrating / Q000601:surgery*; D055815:Young Adult