Comparative Study of National Emergency X-Radiography Utilization Study (NEXUS) Chest Algorithm and Extended Focused Assessment with Sonography for Trauma (E-FAST) Performed by Emergency Physicians in The Early Detection of Blunt Chest Injuries | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 86, Volume 100, Issue 1, July 2025, Page 3138-3144 PDF (535.19 K) | ||||
| DOI: 10.21608/ejhm.2025.442677 | ||||
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| Abstract | ||||
| Background: Observing the disparity between increased imaging utilization and a lack of proportional increase in diagnosed diseases, leading to higher resource waste and patient risks, there was always a call for developing guidelines for directing the usage of imaging in the Emergency Department. Objectives: Evaluating the ability of E-FAST and NEXUS chest algorithms in the early detection of blunt chest injuries in polytrauma patients, with the goal of minimizing costs and harmful radiation exposure. Patients and Methods: Sixty-one polytrauma patients with blunt chest trauma from the emergency room at Menoufia University Hospital were included in this observational cross-sectional study; we noted whether the NEXUS chest clinical criteria were present. After that E-FAST scan was performed, and then a CT was conducted for all patients. We compared the findings of the CT with those of the NEXUS algorithm and E-FAST. Results: In pneumothorax cases, the NEXUS algorithm recorded 100% sensitivity and 10% specificity, whereas E-FAST recorded 87% sensitivity and 98% specificity. In hemothorax cases, the NEXUS algorithm had 100% sensitivity and 11% specificity. In contrast, E-FAST recorded a higher specificity of 100% and a lower sensitivity of 80%. Conclusion: Compared to the NEXUS chest algorithm, which had higher sensitivity than E-FAST, E-FAST demonstrated a higher specificity in identifying pneumothorax and hemothorax in patients with blunt chest injuries. | ||||
| Keywords | ||||
| Chest injuries; E-FAST; Hemothorax; NEXUS algorithm; Polytrauma; Pneumothorax | ||||
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