Extended Focused Assessment with Sonography for Trauma Patients and Base Deficit for Prediction of Outcome in Hemodynamically Unstable Polytrauma Patients

Background:  One-half of deaths because of trauma are related to hemorrhage, so there is high need to recognize it early to prevent the effects of hypovolemic shock, which results in anaerobic metabolism, tissue hypoxia, and metabolic acidosis.     
Objectives: This study aimed to assess the usefulness of E-FAST and BD (base deficit) in the prediction of early surgical intervention and outcome in hemodynamically unstable polytrauma patients.
Patients and methods: This is prospective research done on 120 hemodynamically unstable polytrauma patients, who presented to the Emergency Department of Menoufia University Hospital through the period from August 2023 to August 2024.All patients were assessed by primary survey, BDthatwas assessed before and after resuscitation and E-FAST (extended focused assessment sonography with trauma patients). Their results were evaluated and analyzed to evaluate immediate outcome in ED (Emergency Department).
Results: 120 cases have been involved in this study where males were more than females (84.2 % and 15.8 % respectively). The mean age was 29.1 ± 11.8 years. The road traffic accident (RTA) was observed to be the most common mode of trauma (75 %). By bedside E-FAST, there were 90 % of patients had positive E-FAST. There was a significant effect of E-FAST in prediction of surgical intervention and ICU admission with p value of 0.002 and 0.036 respectively. Also, relationships between base deficit in ABG2 (after resuscitation) and prediction of surgical intervention and ICU admission were statistically significant with p value of < 0.001 and 0.043 respectively.
Conclusion: This study revealed that result of E-FAST and BD improve the ability to predict immediate outcomes in hemodynamically unstable polytrauma patients in ED.