Article Figures & Data
Tables
- Table 1
Baseline demographic, physiologic and biochemical data in patients with and without a FAST examination in the ED
Variable* FAST performed (n=327) FAST not performed (n=118) P value† Age (years) 39 (26–53) 36 (25–52) 0.43 ISS 27 (17–36) 17.5 (9–29) <0.001 AIS head 0 (0–3) 0 (0–3) 0.15 AIS chest 3 (0–3) 1 (0–3) <0.001 AIS abdomen 2 (0–3) 1 (0–3) 0.008 AIS extremity 2 (0–3) 2 (0–3) 0.10 Sex (male) 71.6% 74.6% 0.53 Mechanism (blunt) 75.7% 43.2% <0.001 SBP in field (mm Hg) 84 (71–100.5) 80 (70–91) 0.035 SBP in ED (mm Hg) 80 (70–88.5) 80 (70–86) 0.065 Heart rate (beats per minute) 105 (84–124) 105 (83–120) 0.063 INR 1.3 (1.2–1.5) 1.2 (1.1–1.5) 0.079 Base deficit (mEq/L) 8 (4–12) 8 (4–12) 0.041 pH 7.25 (7.14–7.34) 7.26 (7.14–7.33) 0.055 Lactate (mEq/L) 4.4 (3–6.3) 5.4 (3–9.4) 0.09 Hemoglobin (g/dL) 11.4 (10–12.9) 10.8 (9–12.3) 0.007 Six-hour RBC requirement (units) 4 (2–9) 4.5 (2.5–10) 0.86 Twenty-four-hour RBC requirement (units) 6 (3–12) 5 (3–10) 0.34 *Median values (IQR).
†Wilcoxon rank-sum test or χ2 test.
AIS, abbreviated injury scale; ED, emergency department; FAST, focused assessment with sonography for trauma; INR, international normalized ratio; ISS, Injury Severity Score; RBC, red blood cells; SBP, systolic blood pressure.
- Table 2
Requirement for T-LAP in injured patients with hypotension undergoing FAST
T-LAP (%) No T-LAP (%) Blunt mechanism (n=240) FAST(+) (n=79) 56 (71) 23 (29) FAST(-) (n=161) 32 (20) 129 (80) Penetrating mechanism (n=77) FAST(+) (n=29) 19 (66) 10 (34) FAST(-) (n=48) 15 (31) 33 (69) All patients (n=317) FAST(+) (n=108) 75 (69) 33 (31) FAST(-) (n=209) 47 (22) 162 (78) FAST, focused assessment with sonography for trauma; T-LAP, therapeutic laparotomy.
- Table 3
Abdominal and cardiac surgical procedures conducted in the first 6 hours on patients with hypotension
FAST(+) (n=75) FAST(-) (n=48) Procedure Blunt (n=56) Penetrating (n=19) Blunt (n=33) Penetrating (n=15) Splenectomy or splenorrhaphy 28 3 18 2 Temporary abdominal closure 29 9 14 5 Abdominal packing 27 11 12 5 Liver procedure 19 11 4 4 Hemostasis of liver laceration 13 6 3 4 Perihepatic packing 8 7 2 3 Ligation of hepatic artery/vein 3 1 0 3 Lobectomy or wedge resection 2 0 0 1 Gastrointestinal procedure 17 12 9 6 Small bowel resection 12 4 4 0 Small bowel repair 6 6 2 2 Colon resection 5 6 2 0 Colon repair 6 0 2 2 Creation of stoma 0 0 1 1 Gastric repair 1 2 1 2 Suture of artery or vein 15 11 2 2 Repair of diaphragm 4 4 3 3 Repair of cardiac laceration 0 3 1 3 Repair of bladder 2 2 0 1 Partial resection of pancreas 2 2 1 0 Cholecystectomy 2 1 0 0 Nephrectomy or repair of kidney 1 3 1 1 Vascular shunt placement 0 0 0 1 Totals do not add up due to patients undergoing multiple procedures.
FAST, focused assessment with sonography for trauma.
- Table 4
Binary classification parameters for the ability of FAST to predict the need for T-LAP in injured patients with hypotension
Blunt Penetrating All Sensitivity (%) 64 56 62 Specificity (%) 85 77 83 Positive predictive value (%) 71 66 69 Negative predictive value (%) 80 69 77 Accuracy (%) 77 68 75 FAST, focused assessment with sonography for trauma; T-LAP, therapeutic laparotomy.
