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Predictors of Hoffman et al for Occult Injury in a Patient with a Negative Focused Abdominal Sonogram for Trauma (FAST)

Description

Hoffman et al evaluated patients with negative focused abdominal sonograms for trauma (FAST) for occult injury. They identified risk factors which may identify a patient who may benefit from additional imaging studies. The authors are from the University of Nebraska and the University of New Mexico,.


 

Patient selection: adult with blunt abdominal trauma and a negative FAST exam

 

Occult injury was a negative FAST exam and positive confirmatory test (abdominopelvic CT or exploratory laparotomy).

 

Predictors of occult injuries:

(1) pelvic fracture (odds ratio 3.5)

(2) renal trauma (odds ratio 3.7)

 

If the systolic blood pressure was < 100 mm Hg at any time during the resuscitation, then the odds ratio of a negative FAST and occult injury was 0.37 (probably because the FAST was usually positive).

 


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