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Focused Assessment with Sonography for Trauma FAST Exam: Image Acquisition
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Focused Assessment with Sonography for Trauma FAST Exam: Image Acquisition

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Predictors of False-Negative Focused Assessment With Sonography for Trauma Examination in Pediatric Blunt Abdominal

Grahame E Quan1,2,3, John L Kendall2,3, Michael C Bogseth2

  • 1From the Department of Emergency Medicine, Royal Columbian Hospital, New Westminster, BC, Canada.

Pediatric Emergency Care
|April 19, 2020
PubMed

Insights

False-negative focused assessment with sonography for trauma (FAST) in pediatric blunt abdominal trauma (BAT) did not correlate with patient factors but increased hospital length of stay. Clinicians should exercise caution with initial FAST results in certain pediatric BAT cases.

Area of Science:

  • Pediatric Trauma Surgery
  • Diagnostic Imaging
  • Emergency Medicine

Background:

  • Focused Assessment with Sonography for Trauma (FAST) is a critical tool for evaluating blunt abdominal trauma (BAT).
  • Understanding factors associated with false-negative (FN) FAST results is essential for accurate diagnosis and management in pediatric patients.
  • Previous research has not fully elucidated the predictors of FN FAST in pediatric BAT.

Purpose of the Study:

  • To investigate patient and injury characteristics associated with false-negative (FN) FAST scans in pediatric blunt abdominal trauma (BAT).
  • To evaluate the impact of FN FAST on in-hospital mortality and length of stay (LOS) in this population.

Main Methods:

  • Retrospective cohort study of pediatric patients (<18 years) with BAT from 2002-2013.
  • Included patients with documented FAST and evidence of pathologic free fluid on CT, surgery, or autopsy.
  • Multivariable and bivariate analyses were employed to assess associations between FN FAST and clinical variables.

Main Results:

  • 141 pediatric BAT patients with free fluid were analyzed; no patient or injury characteristics predicted FN FAST.
  • Splenic and bladder injuries, along with high Abbreviated Injury Scale scores for abdomen/extremity, were negatively associated with FN FAST.
  • FN FAST was not associated with mortality but was linked to increased hospital LOS.

Conclusions:

  • Clinicians must be cautious when interpreting initial FAST results in pediatric patients with minor abdominal trauma or suspected non-spleen/bladder injuries.
  • Further research is needed to develop risk stratification tools for safer integration of FAST in pediatric BAT management.
Abstract

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