FAST versus CT for detecting intra-abdominal injury in hemodynamically stable patients after motor vehicle collisions: a systematic review

Background: In hemodynamically stable patients after motor vehicle collisions (MVCs), rapid detection of intra-abdominal injury (IAI) is important to avoid missed injuries. FAST (Focused Assessment with Sonography for Trauma) is a widely used method for bedside screening, and computed tomography (CT) is the principal for evaluation. We aimed to systematically review the data comparing FAST with CT for detection of IAI in hemodynamically stable patients after MVC related blunt abdominal trauma. Methods: our study is A PRISMA based systematic review and our literature search was applied in PubMed, Scopus, and Web of Science. We screened free original studies about FAST in blunt abdominal trauma, with CT and clinical reference standards. A set of 10 original studies were included, cohorts focused on hemodynamically stable blunt trauma and motor vehicle accident populations. Data extraction was done and we extract the study design, population characteristics, hemodynamic status, comparator standard, and diagnostic outcomes. Results: The identified studies were heterogeneous in design, trauma mechanism, age group, and outcome definitions. FAST show a value as a rapid bedside triage tool, but limitations were noted in excluding all IAIs, mainly low volume bleeding and gastrointestinal injuries. CT is the most comprehensive modality for injury detection and characterization in stable patients. Conclusion: FAST is complementary early assessment tool rather than a standard substitute for CT in hemodynamically stable MVC patients with suspected IAI.