Volume 14, Issue 2 (6-2026)
J Surg Trauma 2026, 14(2): 93-97 |
Back to browse issues page
Ethics code: IR.IUMS.FMD.REC.1402.163
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Hafezimoghadam P, Ghadesi M, Rezai M, Abboud Y, Amini Rad T, Mohseni Kia H et al . Prevalence of Positive Focused Assessment With Sonography in Trauma and Its Association with Abdominal Surgery in Asymptomatic Blunt Trauma Patients: A Retrospective Study. J Surg Trauma 2026; 14 (2) :93-97
URL: http://jsurgery.bums.ac.ir/article-1-513-en.html
URL: http://jsurgery.bums.ac.ir/article-1-513-en.html
Peyman Hafezimoghadam 
, Marjan Ghadesi , Mahdi Rezai , Youssef Abboud , Taha Amini Rad , Hoda Mohseni Kia , Alireza Javan *
, Marjan Ghadesi , Mahdi Rezai , Youssef Abboud , Taha Amini Rad , Hoda Mohseni Kia , Alireza Javan *
Emergency Medicine Management Research Center,Health Management Research Institute, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
Abstract: (617 Views)
Introduction: Focused assessment with sonography in trauma (FAST) is widely used during initial trauma evaluation. However, its clinical value in hemodynamically stable and asymptomatic patients remains uncertain, particularly given the potentially limited clinical utility in this population. This study aimed to determine the prevalence of positive FAST findings in asymptomatic blunt trauma patients and evaluate the association between FAST positivity and subsequent abdominal surgery.
Methods: This retrospective study included 1000 consecutive asymptomatic trauma patients with stable vital signs presenting to two tertiary hospitals between 2022 and 2023. FAST results, demographic characteristics, and need for abdominal surgery were extracted from medical records. Comparisons between FAST-positive and FAST-negative groups were performed using independent t-tests and chi-square or Fisher's exact tests. A P value < 0.05 was considered statistically significant.
Results: Positive FAST findings were observed in 12 patients (1.2%; 95% CI: 0.7–2.1%). Five of these patients (41.7%) underwent abdominal surgery, while no surgeries occurred in FAST-negative patients (P<0.001). Due to the lack of systematic computed tomography imaging, the presence of missed non-operative injuries among FAST-negative patients could not be excluded. The small number of positive cases (n=12) resulted in wide confidence intervals and limited inferential power.
Conclusion: FAST positivity was uncommon among asymptomatic trauma patients. Although positive findings were associated with surgical intervention, the study design does not permit assessment of true diagnostic performance. Selective rather than routine use of FAST in this low-risk population may warrant consideration.
Methods: This retrospective study included 1000 consecutive asymptomatic trauma patients with stable vital signs presenting to two tertiary hospitals between 2022 and 2023. FAST results, demographic characteristics, and need for abdominal surgery were extracted from medical records. Comparisons between FAST-positive and FAST-negative groups were performed using independent t-tests and chi-square or Fisher's exact tests. A P value < 0.05 was considered statistically significant.
Results: Positive FAST findings were observed in 12 patients (1.2%; 95% CI: 0.7–2.1%). Five of these patients (41.7%) underwent abdominal surgery, while no surgeries occurred in FAST-negative patients (P<0.001). Due to the lack of systematic computed tomography imaging, the presence of missed non-operative injuries among FAST-negative patients could not be excluded. The small number of positive cases (n=12) resulted in wide confidence intervals and limited inferential power.
Conclusion: FAST positivity was uncommon among asymptomatic trauma patients. Although positive findings were associated with surgical intervention, the study design does not permit assessment of true diagnostic performance. Selective rather than routine use of FAST in this low-risk population may warrant consideration.
Type of Study: Short Communication |
Subject:
Emergency Medicine
Received: 2025/09/30 | Accepted: 2026/02/24 | ePublished ahead of print: 2026/05/9 | Published: 2026/06/6
Received: 2025/09/30 | Accepted: 2026/02/24 | ePublished ahead of print: 2026/05/9 | Published: 2026/06/6
References
1. 1. World Health Organization (WHO). Injuries and violence: The facts. Geneva: WHO; 2021.[URL: sheets/detail/injuries-and-violence]
2. Wang Z, Wang S, Li N, et al. Global, regional and national burden of traumatic brain injury and spinal cord injury, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. BMJ Open. 2023;13(10): e075049. [PMID: 37802626] [DOI:10.1136/bmjopen-2023-075049] [PMID] [PMCID]
3. Osterwalder J, Mathis G, Hoffmann B. New perspectives for modern trauma management-lessons learned from 25 years FAST and 15 years E-FAST. Ultraschall in der Medizin- Ultraschall Med. 2019 Oct;40(05):560-83.[DOI: 10.1055/a-0924-5455] [DOI:10.1055/a-0924-5455] [PMID]
4. Berona K, Kang T, Rose E. Pelvic free fluid in asymptomatic pediatric blunt abdominal trauma patients: a case series and review of the literature. J Emerg Med. 2016 May 1;50(5):753-8.[PMID: 26884127] [DOI:10.1016/j.jemermed.2016.01.003] [PMID]
5. Heydari F, Masoumi B, Zamani M, Nasr-Esfahani M. Prospective evaluation of safe observation period after asymptomatic penetrating thoracic injury: 1 hour is enough. Adv J Emerg Med. 2019 Jun 22;3(4):e39.[DOI: 10.1016/j.jemermed.2016.01.003] [DOI:10.1016/j.jemermed.2016.01.003] [PMID]
6. Laselle BT, Byyny RL, Haukoos JS, Krzyzaniak SM, Brooks J, Dalton TR, Gravitz CS, Kendall JL. False-negative FAST examination: associations with injury characteristics and patient outcomes. Ann Emerg Med.2012 Sep 1;60(3):326-34.[DOI: 10.1016/j.annemergmed.2012.01.023] [DOI:10.1016/j.annemergmed.2012.01.023] [PMID]
7. Vianen NJ, van der Wouden CH, van der Hooft T, et al. Impact of Point-of-Care Ultrasound on prehospital decision making by HEMS physicians in critically ill and injured patients: A prospective cohort study. PDM. 2023;38(4):444-449. [DOI: 10.1017/S1049023X23006003] [DOI:10.1017/S1049023X23006003] [PMID] [PMCID]
8. Choi W, Kim J, Kim H, et al. Role of Point-of-Care Ultrasound in Critical Care and Emergency Medicine: Update and Future Perspective. Clin Exp Emerg Med. 2023 Dec 29;10(4):363[DOI: 10.15441/ceem.23.101] [DOI:10.15441/ceem.23.101] [PMID] [PMCID]
9. Alkathim A, Alfaraj D, Alghamdi MA, Samar AN. Incidental finding of asymptomatic non-traumatic pericardial effusion in a trauma patient: a case report. J Med Life. 2023 Jan;16(1):167.[DOI: 10.25122/jml-2022-0083] [DOI:10.25122/jml-2022-0083] [PMID] [PMCID]
10. Chardoli M, Tajan SK, Esfahani KJ, Mosaddegh R, Vaziri S, Mohammadi F, et al. Diagnostic Accuracy of Ultrasound by Emergency Physicians in Patients with Suspected Small Bowel Obstruction (SBO): A Multi-center Study. Med J Islam Repub Iran. 2025 Jul 7;39:90.[URL:PMC12516411] [DOI:10.47176/mjiri.39.90] [PMID] [PMCID]
11. Seidzadeh Gooklan L, Yari A, Mayel M, Nazemi S, Movahedi M, Mirafzal A. Observation period for asymptomatic penetrating chest trauma. ESTES. 2018 Dec;44(6):829-33[DOI: 10.1007/s00068-015-0623-8] [DOI:10.1007/s00068-015-0623-8] [PMID]
12. Zhang Y, Wang L, Chen X, et al. Early mortality prediction after severe trauma using ensemble machine learning: A single-center retrospective study. Front Public Health. 2025;13:1716910. [DOI: 10.3389/fpubh.2025.1716910] [DOI:10.3389/fpubh.2025.1716910] [PMID] [PMCID]
13. Sozzi M, Lam L, Demetriades D. Asymptomatic COVID-19 Trauma Patients have Worse Outcomes and Resource Use: A Matched Cohort Study. JACS.2022 Nov 1;235(5):S90-1.[DOI: 10.1097/SLA.0000000000005763] [DOI:10.1097/SLA.0000000000005763] [PMID]
14. Li J, Zhang Y, Liu X, et al. Efficacy and safety of corticosteroids for stroke and traumatic brain injury: a systematic review and meta-analysis. J Neurol. 2025;272(4):1125-1135. [DOI: 10.1186/s13643-025-02803-5] [DOI:10.1186/s13643-025-02803-5] [PMID] [PMCID]
15. Choi NH, Kim BY, Bo BH, Victoroff BN. Suture versus FasT-Fix all-inside meniscus repair at time of anterior cruciate ligament reconstruction. Arthroscopy: Arthroscopy.2014 Oct 1;30(10):1280-6.[DOI: 10.1016/j.arthro.2014.05.023] [DOI:10.1016/j.arthro.2014.05.023] [PMID]
16. Ghafouri HB, Zare M, Bazrafshan A, Modirian E, Farahmand S, Abazarian N. Diagnostic accuracy of emergency-performed focused assessment with sonography for trauma (FAST) in blunt abdominal trauma. Electron. Physician 2016 Sep 20;8(9):2950. [URL: .ncbi.nlm.nih.gov/27790349/] [DOI:10.19082/2950] [PMID] [PMCID]
17. Wynne ZR, Davis J, Moore S, Kasmire KE. 314 Prevalence of Asymptomatic Intraperitoneal Fluid in Children on Focused Assessment with Sonography in Trauma Ultrasound. Ann Emerg Med. 2020 Oct 1;76(4):S121-2.[URL: article/S0196-0644(20)31076-3/fulltext] [DOI:10.1016/j.annemergmed.2020.09.329]
18. Laselle BT, Byyny RL, Haukoos JS, Krzyzaniak SM, Brooks J, Dalton TR, et al. False-negative FAST examination: associations with injury characteristics and patient outcomes. Ann Emerg Med. 2012 Sep 1;60(3):326-34.[DOI: 10.1016/j.annemergmed.2012.01.023] [DOI:10.1016/j.annemergmed.2012.01.023] [PMID]
19. Riera A, Hayward H, Silva CT, Chen L. Reevaluation of FAST sensitivity in pediatric blunt abdominal trauma patients: should we redefine the qualitative threshold for significant hemoperitoneum?. Pediatr Emerg Care. 2021 Dec 1;37(12):e1012-9.[DOI: 10.1097/PEC.0000000000001877] [DOI:10.1097/PEC.0000000000001877] [PMID]
20. Lee BC, Ormsby EL, McGahan JP, Melendres G, Richards JR. The Utility of Sonography for the Triage of Blunt Abdominal Trauma Patients to Exploratory Laparotomy. AJR .2007;188(2):415-21.[DOI: 10.2214/AJR.05.2100] [DOI:10.2214/AJR.05.2100] [PMID]
21. Ghafil C, Matsushima K, Guzman R, Owattanapanich N, Reitz MM, Garapati H, et al. Performance of Focused Assessment with Sonography for Trauma Following Resuscitative Thoracotomy for Traumatic Cardiac Arrest. World J Surg. 2021;46(1):91-7.[DOI: 10.1007/s00268-021-06317-8] [DOI:10.1007/s00268-021-06317-8] [PMID]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
Attribution-NoneCommercial CC BY-NC
