title: Should we perform a FAST exam in haemodynamically stable patients presenting after blunt abdominal injury: a retrospective cohort study.
abstract: BACKGROUND
  Focussed 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.
  
  
  METHODS
  In 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).
  
  
  RESULTS
  A 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.
  
  
  CONCLUSIONS
  The FAST exam can provide valuable prognostic information at minimal expenses during the early stages of resuscitation in haemodynamically stable patients presenting with BAT.
  
  
  CONCLUSIONS
  FAST exam should not be omitted in patients with BAT.
authors.affiliation: Department of Emergency Medicine, Medical Center Leeuwarden, Henry Dunantweg 2, 8934 AD, Leeuwarden, The Netherlands.
authors.forename: D
authors.initials: D
authors.lastname: Dammers
authors.affiliation: Department of Trauma surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: El Moumni
authors.affiliation: Medical Student, University of Groningen, Groningen, The Netherlands.
authors.forename: I I
authors.initials: II
authors.lastname: Hoogland
authors.affiliation: Department of Epidemiology, University of Groningen, University Medical Center Groningen and Medical Center Leeuwarden, Groningen, The Netherlands.
authors.forename: N
authors.initials: N
authors.lastname: Veeger
authors.affiliation: Department of Emergency Medicine, Medical Center Leeuwarden, Henry Dunantweg 2, 8934 AD, Leeuwarden, The Netherlands. teravestewoud@hotmail.com.
authors.forename: E
authors.identifier: http://orcid.org/0000-0002-1462-6130
authors.initials: E
authors.lastname: Ter Avest
mesh_terms: D000007:Abdominal Injuries / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy; D000328:Adult; D003657:Decision Making; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D014463:Ultrasonography / Q000379:methods*; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy
keywords: Blunt abdominal injury; FAST; Focussed Assessment with Sonography for Trauma