Evidence map›Paper›PMID 39789295›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2025

Diagnostic performance of prehospital EFAST in predicting CT scan injuries in severe trauma patients: a multicenter cohort study.

Dino Tikvesa, Camille Vogler, Frederic Balen, Marianne Le Dortz, Romain Genre Grandpierre, Philippe Le Conte, Xavier Bobbia, Thibaut Markarian

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Dino TikvesaEmergency Department, Montpellier University, Montpellier University Hospital, Montpellier, France. dtikvesa@gmail.com.
Camille VoglerEmergency Department, Montpellier University, Montpellier University Hospital, Montpellier, France.
Frederic BalenEmergency Department, Toulouse University, Toulouse University Hospital, Toulouse, France.
Marianne Le DortzEmergency Department, Montpellier University, Montpellier University Hospital, Montpellier, France.
Romain Genre GrandpierreEmergency Department, Montpellier University, Nîmes University Hospital, Nîmes, France.
Philippe Le ConteEmergency Department, Nantes University, University Hospital of Nantes, Nantes, France.
Xavier BobbiaUR UM 103 IMAGINE, Emergency Department, Montpellier University, Montpellier University Hospital, Montpellier, France.
Thibaut MarkarianDepartment of Emergency Medicine, Assistance publique des hôpitaux de Marseille (APHM), Marseille University, Timone University Hospital, Marseille, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe early mortality of trauma patients, mainly from hemorrhagic shock, raises interest in detecting the presence of non-exteriorized bleeding. Intra-hospital EFAST (Extended Focused Assessment with Sonography for Trauma) has demonstrated its utility in the assessment and management of severe trauma patients (STP). However, there is a lack of data regarding the diagnostic performance of prehospital EFAST (pEFAST). The main objective of our study was to evaluate the pEFAST performance to predict a positive CT scan in STP.

methodsThis was a retrospective, multicenter, database-driven study. All severe trauma patients managed by a prehospital medical team were included. The results of pEFAST were compared with the admission CT scan.

resultsData from 495 patients were included. The pEFAST had sensitivity of 27% (95% CI 22; 32) and specificity of 94% (95% CI 90; 97) for predicting the presence of a lesion on CT scan at hospital admission. The area under the curve (AUC) was 0.66 (95% CI 0.57; 0.63), the positive predictive value 84% (95% CI 75; 87), the negative predictive value was 51% (95% CI 44; 66), the positive likelihood ratio was 4.24 (95% CI 2.46; 7.3) and the negative likelihood ratio 0.78 (95% CI 0.72; 0.85).

conclusionPrehospital EFAST has an excellent specificity but a poor sensitivity for predicting a positive CT scan on hospital admission. We do not know whether this low sensitivity is secondary to the delay between the two examinations or to the poor performance of pEFAST. Therefore, a negative pEFAST should not be reassuring. A positive pEFAST is highly informative, as it predicts a lesion and enables hospital management to be prepared accordingly.

Indexed as

Focused Assessment with Sonography for TraumaInjury Severity ScorePredictive Value of TestsTomography, X-Ray ComputedWounds and InjuriesAdultAgedCohort StudiesEmergency Medical ServicesFemaleHumansMaleMiddle AgedRetrospective StudiesSensitivity and SpecificityEFASTEmergency departmentMajor traumaPrehospitalUltrasound

Identifiers

PMID39789295

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