Detection of pneumothoraces in patients with multiple blunt trauma: use and limitations of eFAST

Emergency Medicine Journal : EMJ
Thomas C SauterDominik G Haider

Abstract

Extended focused assessment with sonography for trauma (eFAST) has been shown to have moderate sensitivity for detection of pneumothorax in trauma. Little is known about the location or size of missed pneumothoraces or clinical predictors of pneumothoraces in patients with false-negative eFAST. This retrospective cross-sectional study includes all patients with multiple blunt trauma diagnosed with pneumothorax who underwent both eFAST and CT performed in the ED of a level 1 trauma centre in Switzerland between 1 June 2012 and 30 September 2014. Sensitivity of eFAST for pneumothorax was determined using CT as the gold standard. Demographic and clinical characteristics of those who had a pneumothorax detected by eFAST and those who did not were compared using the Mann-Whitney U or Pearson's χ(2) tests. Univariate binary logistic regression models were used to identify predictors for pneumothoraces in patients with negative eFAST examination. The study included 109 patients. Overall sensitivity for pneumothorax on eFAST was 0.59 and 0.81 for pneumothoraces requiring treatment. Compared with those detected by eFAST, missed pneumothoraces were less likely to be ventral (30 (47.6%) vs 4 (9.3%), p <0.001) and more likely to be apical ...Continue Reading

References

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Citations

Nov 13, 2019·European Journal of Emergency Medicine : Official Journal of the European Society for Emergency Medicine·Prudence OliverRichard M Lyon
Dec 15, 2018·The Cochrane Database of Systematic Reviews·Dirk StengelAlexander Hoenning
Sep 10, 2019·World Journal of Emergency Surgery : WJES·Ashraf F HefnyFikri M Abu-Zidan

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Software Mentioned

eFAST
SPSS Statistics

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