Introduction: Hemothorax is one of the most prevalent complications after thoracic trauma. Extended Focused Assessment with Sonography for Trauma (e-FAST) is one of the diagnostic methods for hemothorax assessment. This study aimed to assess the diagnostic value of e-FAST in detecting hemothorax and its size in patients with blunt thoracic trauma.
Methods: This cross-sectional diagnostic assessment was conducted on 400 adult patients with blunt trauma who needed a chest CT scan. Chest X-ray (CXR), sonography, and chest CT scans were performed and hemothorax size was assessed with sonography and CT-scan. Sensitivity, specificity, and positive or negative predictive values of sonography and CXR were calculated. Hemothorax size on sonography was compared with the results of CT-scan as the gold standard.
Results: The mean age of participants was 43.67±22.03. Based on CT scan findings, 176 participants (44%) had a hemothorax. The sensitivity, specificity, positive and negative predictive values, and correct classification rate of sonography were 79%, 99.1%, 98.6%, 85.7%, and 90.2%, respectively. The accuracy of sonography was 97.1% for small hemothorax, 46.9% for medium hemothorax, and 33.3% for large hemothorax.
Conclusion: Sonography is a sensitive diagnostic modality for the detection of hemothorax in multiple trauma patients but tends to underestimate moderate to large-sized hemothorax. Chest sonography can be an acceptable imaging modality if a CT scan is not available or desired.
Keywords: Hemothorax, sonography, trauma, e-FAST.