Diagnostic Accuracy of Extended Focused Assessment with Sonography in Trauma (eFAST) for Detection of Blunt Chest Injuries: A Prospective Study Comparing EFAST with CT Chest

Background: Blunt chest trauma is a major cause of illness and death in trauma patients. Early detection of injuries such as pneumothorax and haemothorax is important for timely treatment. Computed tomography (CT) of the chest is the diagnostic gold standard. However, CT may not be easily available in emergency settings due to time and logistical constraints. Extended focused assessment with sonography in trauma (eFAST) provides a rapid bedside imaging option for early diagnosis. Objectives: To evaluate the diagnostic accuracy of eFAST in detecting blunt chest injuries in trauma patients, using CT chest as the reference standard. Methods: This prospective diagnostic accuracy study was conducted in the Department of Emergency Medicine at a tertiary care teaching hospital in Tamil Nadu over one year. Ninety-nine hemodynamically stable patients with suspected blunt chest trauma underwent bedside eFAST followed by CT chest. The diagnostic performance of eFAST was assessed using sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV). Results: Among the 99 patients studied, eFAST showed high specificity (100%) for all thoracic injuries. The sensitivity of eFAST was 75.0% for pneumothorax, 76.9% for haemothorax, 78.9% for rib fractures, and 50.0% for lung contusions. For detection of any chest injury, eFAST showed a sensitivity of 78.1% and a specificity of 100%. The PPV was 100% and the NPV was 90.5%. Conclusion: eFAST is a highly specific and reliable bedside tool for the early detection of blunt chest injuries, especially pneumothorax, haemothorax, and rib fractures. Although CT chest remains the definitive imaging modality, eFAST is an effective screening and triage tool in emergency and resource-limited settings.