Volume 12, Issue 3 (11-2024)
J Surg Trauma 2024, 12(3): 95-100 |
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Rahmanian Sharifabad A, Forouhar F, Ghafoor L, Akbari H, Mousavi E. The Diagnostic Value of Focused Assessment with Sonography for Trauma Ultrasound in Children with Blunt Abdominal Trauma: Assessing Accuracy and Clinical Utility. J Surg Trauma 2024; 12 (3) :95-100
URL: http://jsurgery.bums.ac.ir/article-1-387-en.html
URL: http://jsurgery.bums.ac.ir/article-1-387-en.html
Amir Rahmanian Sharifabad 
, Farnood Forouhar * , Leila Ghafoor , Hossein Akbari , Elhamsadat Mousavi
, Farnood Forouhar * , Leila Ghafoor , Hossein Akbari , Elhamsadat Mousavi
Department of Surgery, Trauma Research Center, Kashan University of Medical Sciences, Kashan, Iran
Abstract: (744 Views)
Introduction: Understanding the strengths and limitations of imaging techniques is essential for accurate diagnosis and optimal management of patients with blunt abdominal trauma. This study assessed the diagnostic accuracy of Focused Assessment with Sonography for Trauma (FAST) ultrasound in pediatric blunt abdominal trauma.
Methods: This retrospective study analyzed the medical records of 314 pediatric patients from the trauma center at Shahid Beheshti Hospital, Kashan, Iran. Demographic data, FAST results, and computed tomography (CT) findings were collected and interpreted by a radiologist. The obtained data were analyzed using the Chi-square test or Fisher's exact test. Moreover, SPSS software (version 16) was used to examine sensitivity and specificity, as well as positive and negative predictive values. A p-value of 0.05 was considered statistically significant.
Results: CT scans showed abnormalities in 70% of patients, with 154 (70%) male patients. No significant association of trauma mechanism, gender, age, and Glasgow Coma Scale (GCS) scores with CT results (P>0.05) was found in this study. However, abdominal tenderness was associated with CT results (P=0.004). Abnormal FAST correlated with abnormal CT (P<0.001). FAST demonstrated significant diagnostic value in pediatric blunt abdominal trauma, and abdominal tenderness emerged as a relevant indicator.
Conclusion: FAST can be a valuable initial screening tool, aiding in timely and accurate management decisions for patients with blunt abdominal trauma. Further investigation is needed to explore factors influencing the correlation between FAST and CT in critically ill patients with GCS<13.
Methods: This retrospective study analyzed the medical records of 314 pediatric patients from the trauma center at Shahid Beheshti Hospital, Kashan, Iran. Demographic data, FAST results, and computed tomography (CT) findings were collected and interpreted by a radiologist. The obtained data were analyzed using the Chi-square test or Fisher's exact test. Moreover, SPSS software (version 16) was used to examine sensitivity and specificity, as well as positive and negative predictive values. A p-value of 0.05 was considered statistically significant.
Results: CT scans showed abnormalities in 70% of patients, with 154 (70%) male patients. No significant association of trauma mechanism, gender, age, and Glasgow Coma Scale (GCS) scores with CT results (P>0.05) was found in this study. However, abdominal tenderness was associated with CT results (P=0.004). Abnormal FAST correlated with abnormal CT (P<0.001). FAST demonstrated significant diagnostic value in pediatric blunt abdominal trauma, and abdominal tenderness emerged as a relevant indicator.
Conclusion: FAST can be a valuable initial screening tool, aiding in timely and accurate management decisions for patients with blunt abdominal trauma. Further investigation is needed to explore factors influencing the correlation between FAST and CT in critically ill patients with GCS<13.
Keywords: Abdominal Injuries, Computed Tomography, Focused Assessment with Sonography for Trauma, Pediatrics
Type of Study: Research |
Subject:
General Surgery
Received: 2023/06/25 | Accepted: 2024/10/2 | ePublished ahead of print: 2024/12/31 | Published: 2025/01/4
Received: 2023/06/25 | Accepted: 2024/10/2 | ePublished ahead of print: 2024/12/31 | Published: 2025/01/4
References
1. Holmes JF, Panacek EA, Miller PQ, Lapidis AD, Mower WR. Prospective evaluation of criteria for obtaining thoracolumbar radiographs in trauma patients. J Emerg Med. 2003;24(1):1-7. [DOI:10.1016/S0736-4679(02)00659-5]
2. Holmes JF, Lillis K, Monroe D, Borgialli D, Kerrey BT, Mahajan P, et al. Identifying Children at Very Low Risk of Clinically Important Blunt Abdominal Injuries. Ann Emerg Med. 2013;62(2):107-16.e2. [DOI:10.1016/j.annemergmed.2012.11.009]
3. Nayak SR, Yeola MP, Nayak SR, Kamath K, Raghuwanshi PS. Role of focused assessment with sonography for trauma in the assessment of blunt abdominal trauma-a review. J Evol Med Dent Sci. 2021;10(1):45-51. [DOI:10.14260/jemds/2021/9]
4. Riera A, Hayward H, Torres Silva C, 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;37(12):e1012-e9. [DOI:10.1097/PEC.0000000000001877]
5. Bahrami-Motlagh H, Hajijoo F, Mirghorbani M, SalevatiPour B, Haghighimorad M. Test characteristics of focused assessment with sonography for trauma (FAST), repeated FAST, and clinical exam in prediction of intra-abdominal injury in children with blunt trauma. Pediatr Surg Int. 2020;36(10):1227-34. [DOI:10.1007/s00383-020-04733-w]
6. Khan M, Uzair M, Yousaf J, Waqas A, Khalid S, Haider SI, et al. Frequency of Correct Findings of Abdominal Ultrasonography Compared with CT Scan in Detection of Solid Intra-Abdominal Visceral Injuries. J Health Med Sci. 2019;2(3):256-63. [DOI:10.31014/aior.1994.02.03.45]
7. Abdolrazaghnejad A, Banaie M, Safdari M. Ultrasonography in Emergency Department; a Diagnostic Tool for Better Examination and Decision-Making. Advanced journal of emergency medicine. 2018;2(1):e7.
8. Liang T, Roseman E, Gao M, Sinert R. The utility of the focused assessment with sonography in trauma examination in pediatric blunt abdominal trauma: a systematic review and meta-analysis. Pediatr Emerg Care. 2021;37(2):108-18. [DOI:10.1097/PEC.0000000000001755]
9. Achatz G, Schwabe K, Brill S, Zischek C, Schmidt R, Friemert B, et al. Diagnostic options for blunt abdominal trauma. Eur J Trauma Emerg Surg. 2022;48(5):3575-89. [DOI:10.1007/s00068-020-01405-1]
10. Ullah N, Bacha R, Manzoor I, Gilani SA, Gilani SMYF, Haider Z. Reliability of Focused Assessment With Sonography for Trauma in the Diagnosis of Blunt Torso Trauma. J Diag Med Sono. 2022;38(1):60-70. [DOI:10.1177/87564793211029849]
11. Sargent W, Bull A, Gibb I. Focused Assessment with Sonography in Trauma (FAST) performance in paediatric conflict injury. Clin Radiol. 2022;77(7):529-34. [DOI:10.1016/j.crad.2022.04.001]
12. Saleh M, Salamah A. Role of ultrasonography, computed tomography and diagnostic peritoneal lavage in abdominal blunt trauma. Saudi Med J. 2002;23(11):1350-5.
13. Wurmb TE, Frühwald P, Hopfner W, Keil T, Kredel M, Brederlau J, et al. Whole-body multislice computed tomography as the first line diagnostic tool in patients with multiple injuries: The focus on time. J Trauma Acute Care Surg. 2009;66(3):658-65. [DOI:10.1097/TA.0b013e31817de3f4]
14. Sepuya RG, Dozeman ET, Prittie JE, Fischetti AJ, Weltman JG. Comparing diagnostic findings and cost of whole body computed tomography to traditional diagnostic imaging in polytrauma patients. J Vet Emerg Crit Care. 2022;32(3):334-40. [DOI:10.1111/vec.13189]
15. Chien L-C, Vakil M, Nguyen J, Chahine A, Archer-Arroyo K, Hanna TN, et al. The American Association for the Surgery of Trauma Organ Injury Scale 2018 update for computed tomography-based grading of renal trauma: a primer for the emergency radiologist. Emerg Radiol. 2020;27(1):63-73. [DOI:10.1007/s10140-019-01721-z]
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