Comparative Study of National Emergency X-Radiography Utilization Study (NEXUS) Chest Algorithm and Extended Focused Assessment with Sonography for Trauma (E-FAST) Performed by Emergency Physicians in The Early Detection of Blunt Chest Injuries

Background: Observing the disparity between increased imaging utilization and a lack of proportional increase in diagnosed diseases, leading to higher resource waste and patient risks, there was always a call for developing guidelines for directing the usage of imaging in the Emergency Department.
Objectives: Evaluating the ability of E-FAST and NEXUS chest algorithms in the early detection of blunt chest injuries in polytrauma patients, with the goal of minimizing costs and harmful radiation exposure.
Patients and Methods: Sixty-one polytrauma patients with blunt chest trauma from the emergency room at Menoufia University Hospital were included in this observational cross-sectional study; we noted whether the NEXUS chest clinical criteria were present. After that E-FAST scan was performed, and then a CT was conducted for all patients. We compared the findings of the CT with those of the NEXUS algorithm and E-FAST.
Results: In pneumothorax cases, the NEXUS algorithm recorded 100% sensitivity and 10% specificity, whereas E-FAST recorded 87% sensitivity and 98% specificity. In hemothorax cases, the NEXUS algorithm had 100% sensitivity and 11% specificity. In contrast, E-FAST recorded a higher specificity of 100% and a lower sensitivity of 80%.
Conclusion: Compared to the NEXUS chest algorithm, which had higher sensitivity than E-FAST, E-FAST demonstrated a higher specificity in identifying pneumothorax and hemothorax in patients with blunt chest injuries.