Eur J Trauma Emerg Surg. 2025 Nov 6;51(1):325. doi: 10.1007/s00068-025-02988-3.
ABSTRACT
PURPOSE: Trauma is a leading cause of mortality worldwide, especially in low- and middle-income countries (LMICs), where diagnostic resources are limited. This study evaluated whether early Focused Assessment with Sonography for Trauma (FAST) reduces mortality and resource use in polytrauma patients in a low-resource setting.
METHODS: We conducted a single-center, randomized controlled trial among adults with severe trauma admitted to the emergency department of a tertiary hospital in Morocco. Patients were randomized to standard care or a protocol incorporating FAST during initial triage. The primary outcome was in-hospital mortality. Secondary endpoints included 30-day mortality, time to surgery, CT use, transfusion needs, and hospital stay. Multivariable logistic regression and survival analyses were performed.
RESULTS: A total of 157 patients were enrolled (77 control, 80 FAST). In-hospital mortality was significantly lower in the FAST group (39.2% vs. 66.2%, p = 0.001). Thirty-day mortality was also reduced (45.6% vs. 72.7%, p = 0.001). FAST use was associated with decreased odds of in-hospital death (adjusted OR 0.48; p = 0.050) and improved survival time (HR 0.56; p = 0.014). Fewer patients underwent CT in the FAST group (82.5% vs. 96.1%, p = 0.006), and time to surgery was shorter (5.16 vs. 9.82 h, p < 0.001).
CONCLUSION: Early use of FAST significantly reduced mortality, CT use, and surgical delays. These findings support guideline recommendations for integrating FAST into trauma triage protocols, particularly in LMICs.
TRIAL REGISTRATION: PACTR202507728817990 (retrospectively registered).
PMID:41196403 | DOI:10.1007/s00068-025-02988-3
