Résumé
Intra-hospital FAST (Focused Assessment with Sonography for Trauma) has established its interest in the assessment and management of severe trauma patients. Current recommendations do not permit us to decide on its use in prehospital. The aim of this study was to evaluate the diagnostic performances of prehospital FAST (pFAST) compared to CT scan. Methods: this was a retrospective, multicenter study, database-driven study. All severe trauma patients managed by a prehospital medical team were included. The pFAST results were comparedto the admission CT scan. Results: a total of 495 patients were included. pFAST had a sensitivity of 27% 95% CI [22%; 32%] and a specificity of 94% 95% CI [90%; 97%] for predicting the presence of a lesion on CT scan at hospital admission. The area under the curve (AUC) was 0.66 95% CI [0.57; 0.63], the positive predictive value 84% 95% CI [75%; 87%] and the negative predictive value 51% 95% CI [44%; 66%]. Conclusion: pFAST has excellent specificity but lower sensitivity for predicting the presence of lesions than CT scan. Its early practice and a hemodynamically stable population could have an impact on sensitivity. Detection of an effusion by pFAST confirms that the patient is serious and guides both pre-hospital and intra-hospital management. On the other hand, a negative pFAST does not allow us to dispense for an initial CT scan.