Increased body mass index does not impact the imaging quality of focused assessment with sonography in trauma.

Background: Many clinicians believe that a patient's body mass index (BMI) affects the likelihood of obtaining high quality ultrasound images.

Objectives: To assess the hypothesis that increased BMI is associated with worsening focused assessment with sonography in trauma (FAST) image quality.

Methods: We conducted a retrospective single-center study of FAST examinations performed in a large academic emergency department (ED) with fellowship-trained emergency ultrasonography faculty performing quality assurance review.

Results: Mean (SD) BMI was 28.0 (6.6) among the 302 included studies. The overall quality rating tended to decrease as BMI increased but did not achieve statistical significance in a univariable setting (P = .06) or after adjustment for age and sex (P = .06). Operators perception of image adequacy was largely unaffected by BMI, with the exception of the pericardial view.

Conclusion: This study did not identify a statistically significant difference in FAST quality with increased BMI. This result may help assuage clinician concerns about ultrasonography for patients in the ED.