Jurnal Internasional Afrika vol. 13 issue 2 2023
African Journal of Emergency Medicine
Comparative study of National Emergency X-Radiography Utilization Study (NEXUS) chest algorithm and extended focused assessment with sonography for trauma (E-FAST) in the early detection of blunt chest injuries in polytrauma patients

Jurnal Internasional Afrika vol. 13 issue 2 2023
African Journal of Emergency Medicine
Comparative study of National Emergency X-Radiography Utilization Study (NEXUS) chest algorithm and extended focused assessment with sonography for trauma (E-FAST) in the early detection of blunt chest injuries in polytrauma patients

Pneumothorax Hemothorax E-FAST NEXUS Blunt chest trauma

Introduction: Chest imaging plays a prominent role in the assessment of patients with blunt trauma. Selection of the right approach at the right time is fundamental in the management of patients with blunt chest trauma .
[1] A reliable, economic, bedside, and rapidly accomplished screening test can be pivotal.
[2] Objective: The aim of this study was to compare the accuracy of extended- focused assessment with sonography for trauma (E-FAST) to that of the National Emergency X-Radiography Utilisation Study (NEXUS) chest algorithm in detecting blunt chest injuries. Methods: This descriptive cross-sectional study included 50 polytrauma patients with blunt chest trauma from the emergency centre of Suez Canal University Hospital. E-FAST and computed tomography (CT) were conducted, followed by reporting of NEXUS criteria for all patients. Blinding of the E-FAST performer and CT reporter were confirmed. The results of both the NEXUS algorithm and E-FAST were compared with CT chest results. Results: The NEXUS algorithm had 100% sensitivity and 15.3% specificity, and E-FAST had 70% sensitivity and 96.7% specificity, in the detection of pneumothorax. In the detection of hemothorax, the sensitivity and specificity of the NEXUS algorithm were 90% and 7.5%, respectively, whereas E-FAST had a lower sensitivity of 80% and a higher specificity of 97.5%. Conclusion: E-FAST is highly specific for the detection of hemothorax, pneumothorax, and chest injuries compared with the NEXUS chest algorithm, which demonstrated the lowest specificity. However, the NEXUS chest algorithm showed a higher sensitivity than E-FAST and hence can be used effectively to rule out thoracic injury.

Yasmin Z. Attia
a ,
∗ , Nashwa M. Abd Elgeleel
a , Hazem M. El-Hariri
b , Gouda M. Ellabban
c , Maged El-SETOUHY
d ,
e ,
i , Jon Mark Hirshon
f , Adel H Elbaih
a ,
# , Mohamed El-Shinawi

www.elsevier.com/locate/afjem

15 February 2023

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