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Purpose <p>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.</p> Methods <p>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.</p> Results <p>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%, <i>p</i> = 0.001). Thirty-day mortality was also reduced (45.6% vs. 72.7%, <i>p</i> = 0.001). FAST use was associated with decreased odds of in-hospital death (adjusted OR 0.48; <i>p</i> = 0.050) and improved survival time (HR 0.56; <i>p</i> = 0.014). Fewer patients underwent CT in the FAST group (82.5% vs. 96.1%, <i>p</i> = 0.006), and time to surgery was shorter (5.16 vs. 9.82&#xa0;h, <i>p</i> &lt; 0.001).</p> Conclusion <p>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.</p> Trial registration <p>PACTR202507728817990 (retrospectively registered).</p>

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Impact of early FAST ultrasound on severe trauma outcomes: a randomized trial in a low-resource African emergency setting (The ALIFAST Trial)

  • 期刊论文

  • 发表日期：

    2025年11月6日

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  • Ali Kettani,
  • Hajar Moujtahid,
  • Larbi Aberouch,
  • Salim Chajai,
  • Sidi Jawad Tadili,
  • Mamoun Faroudy

摘要

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).