The role of focused assessment sonography for trauma (FAST) on the outcomes in patients with blunt abdominal trauma following non-operative therapy: A cohort study

BACKGROUND: The non-operative management of blunt abdominal trauma had a high success rate and is expected to reduce the length of hospitalization and patients' morbidity. Here, we aim to evaluate the outcomes of patients with blunt abdominal trauma after non-operative management and associate them with prognostic factors. METHODS: We performed a retrospective analysis on patients with blunt abdominal trauma who received non-operative management (NOM) at our institution from April 2018 to April 2021. RESULTS: Two hundred eleven patients were included in this study who underwent non-operative management. Most of the subjects (73%) were males, with male to female ratio of 2.7:1. Most patients aged 20–29 years old (29.4%), FAST negative (62.1%), minor injured (45%), successfully managed nonoperatively (98.6%), received no transfusion (38.9%), and injured due to traffic accident (80.1%). ISS was significantly associated with FAST (p = 0.028), while male gender, NLR, PLR, and blood transfusion did not (p > 0.05). The presence of external injury was associated with FAST results (p = 0.039), while the head, facial, thoracic, pelvic, and skeletal injuries did not (p > 0.05). We also found a significant correlation between blood transfusion and patient survival with NOM outcomes (p = 0.047 and p = 0.041, respectively). Furthermore, external injury significantly correlated with NOM outcomes (p = 0.042). Multivariate analysis showed that external and pelvic injury was significantly associated with NOM outcomes (p < 0.0001 and p = 0.036, respectively). CONCLUSIONS: The results of the FAST examination were not associated with the outcome of non-operative therapy. Moreover, the successful outcome of NOM might be affected by blood transfusions, the presence of external injuries, and pelvic injury.