The Effect of BMI on eFAST Accuracy in Trauma by Residents in the Emergency Room

Am Surg. 2023 Jul;89(7):3238-3240. doi: 10.1177/00031348231157851. Epub 2023 Feb 17.

Abstract

Blunt trauma patients are often evaluated with extended focused assessment with sonography for trauma (eFAST). eFAST is a noninvasive, rapid, ultrasound-guided assessment for hemoperitoneum, pericardial effusion, and hemopneumothorax. Specificity and sensitivity are as high as 95% and 74%, respectively. Research suggests obesity confers increased morbidity and mortality and is an independent risk factor for trauma death. A previous study demonstrated that a BMI change from 36 to 40 changed the odds ratio for inaccurate eFAST from 1.85 to 3.12. Our current prospective data collection is 202 consecutive blunt trauma patients from 5/13/22 to 8/18/22 receiving an eFAST and a CT/OR for comparison. Odds ratio of inaccurate eFAST increased by 5.65% for each increase of 1 kg/m3 of BMI (95% Cl 0.1%-10.8%). This research also investigated surgical resident eFAST accuracy to improve patient outcomes through the implementation of individualized training in normal and obese models.

Keywords: eFAST; obesity; resident education.

MeSH terms

  • Body Mass Index
  • Emergency Service, Hospital
  • Focused Assessment with Sonography for Trauma*
  • Humans
  • Obesity / complications
  • Sensitivity and Specificity
  • Thoracic Injuries*
  • Ultrasonography
  • Wounds, Nonpenetrating* / diagnostic imaging