Abstract

During the initial assessment of trauma patients they usually undergo a Focused Assessment with Sonography for Trauma (FAST) in which there are occasionally incidental findings of other surgical conditions. In this audit we discuss the incidence, demographics, and implications of these findings and we propose a management algorithm. Within 2 years we managed 6041 trauma patients in the emergency department based on the Advanced Trauma Life Support protocols, 95 per cent of which underwent a FAST ultrasound. Incidental findings were reported in 468 patients (7.8%), whereas in a further 11.2 per cent of these patients there was a second finding. The mean age of these patients was 57.55 years (15-105), and most of them were men (51.1%). The vast majority of the findings were related to the liver and biliary tree (52.1%) followed by the urinary track (27.1% + 8%). In multivariate analysis only the age was a significant factor associated with incidental findings (P < 0.001) whereas in univariate analysis both the gender [men (54.1%) vs women (45.9), P = 0.013] and the mechanism of trauma (P < 0.001) were as important as the age (P < 0.001). The patients who had incidental findings were 15 years older than the rest. The detection of unknown surgical conditions in FAST may lead to managerial and possible medico-legal issues rendering the development of a proper algorithm mandatory.

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Publisher Full Text

Authors

Lanitis S, Zacharioudakis C, Zafeiriadou P, Armoutides V, Karaliotas C, Sgourakis G

Institution

Second Surgical Department and Unit of Surgical Oncology, Korgialenio-Benakio, Red Cross Athens General Hospital, Athens, Greece. drlanitis@yahoo.com

Source

The American surgeon 78:3 2012 Mar pg 366-72

MeSH

Adolescent
Adult
Aged
Aged, 80 and over
Algorithms
Aortic Aneurysm, Abdominal
Comorbidity
Female
Female Urogenital Diseases
Gastrointestinal Diseases
Humans
Incidence
Incidental Findings
Logistic Models
Male
Male Urogenital Diseases
Middle Aged
Urologic Diseases
Wounds and Injuries
Young Adult

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22524779