Diagnostic Accuracy of Focused Assessment with Sonography for Trauma (FAST) in the Initial Evaluation of Abdominal Stab Wounds
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Abstract
Objective: This study aimed to determine the accuracy of Focused Assessment with Sonography for Trauma (FAST) in screening patients with penetrating abdominal stab injuries who require emergency laparotomy.
Materials and Methods: A retrospective study was conducted on 269 patients admitted to the Trauma Center of Bhumibol Adulyadej Hospital with stab wounds to the anterior abdomen, thoracoabdomen, or flank. FAST was performed as an adjunct to the primary survey to assess abdominal injury. Patient data, including demographics, physical examination findings, FAST and CT results, surgical procedures, and treatment outcomes, were analyzed. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of FAST for predicting successful non-operative management were calculated and reported with 95 % confidence intervals. Outcomes of patients who underwent surgery were compared with those successfully managed non-operatively using chi-square and Fisher’s exact tests.
Results: The FAST results included 59.7 % true positives (TP), 99.0 % true negatives (TN), 1.0 % false negatives (FN), and 40.3 % false positives (FP). The sensitivity of FAST was 95.24 % (95% CI: 83.84–99.42), specificity was 88.11 % (95% CI: 83.17–92.01), PPV was 59.70 % (95% CI: 50.81–67.99), NPV was 99.01 % (95% CI: 96.27–99.74), and overall accuracy was 89.22 % (95% CI: 84.89–92.66).
Conclusion: FAST is a rapid and accurate initial diagnostic modality for evaluating patients with abdominal
stab wounds. Its high sensitivity and specificity may help reduce unnecessary laparotomies.
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