Transarterial embolisation is associated with improved survival in patients with pelvic fracture: propensity score match
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ORIGINAL ARTICLE
Transarterial embolisation is associated with improved survival in patients with pelvic fracture: propensity score matching analyses Hohyun Kim1,2,3 · Chang Ho Jeon2,3,4 · Jae Hun Kim1,2,3 · Hyun‑Woo Sun1,2 · Dongyeon Ryu1,2 · Kang Ho Lee1,2 · Chan Ik Park1,2 · Jae Hoon Jang2,3,5 · Sung Jin Park1,2 · Seok Ran Yeom2,3,6 Received: 6 April 2020 / Accepted: 8 September 2020 © The Author(s) 2020
Abstract Introduction Transarterial embolisation (TAE) is an effective intervention for management of arterial haemorrhage associated with pelvic fracture. However, its effects on survival and clinical outcomes are unclear. Methods Trauma patients with survival data between November 2015 and December 2019 were identified using a trauma database. Patients were divided between TAE and non-TAE groups, and a propensity score was developed using multivariate logistic regression. Survival at 28 days was compared between the groups after propensity score matching. Results Among 881 patients included in this study, 308 (35.0%) were treated with TAE. After propensity score matching, 130 pairs were selected. Survival at 28 days was significantly higher among patients treated with TAE than among those treated without TAE [122 (93.9%) vs. 112 (86.2%); odds ratio = 2.45; 95% CI 1.02–5.86; p = 0.039]. Conclusions TAE use was associated with improved survival at 28 days in patients with pelvic fracture and should therefore be considered in the management of severely injured patients with pelvic fracture. Keywords Multiple trauma · Therapeutic embolisation · Pelvic bone · Survival · Propensity score matching
Introduction Despite recent advances in trauma surgery, successful treatment of severe pelvic fractures remains challenging. The overall mortality of pelvic fractures is 5–10%, increasing * Jae Hun Kim [email protected] Hohyun Kim [email protected] 1
Department of Trauma and Surgical Critical Care, Pusan National University Hospital, 179 Gudeok‑Ro, Seo‑Gu, Busan 602‑739, Korea
2
Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
3
Pusan National University School of Medicine, Yangsan, Korea
4
Department of Diagnostic Radiology, Pusan National University Hospital, Busan, Korea
5
Department of Orthopaedic Surgery, Pusan National University Hospital, Busan, Korea
6
Department of Emergency Medicine, Pusan National University Hospital, Busan, Korea
to 60% in patients with haemodynamic instability [1–3]. Bleeding is the major cause of death after severe pelvic fracture; the origin of the bleeding can be arterial, venous, or bone-related [4]. Arterial bleeding produces the most severe haemorrhage and frequently results in hypotension [5]. Rapid control of haemorrhage is associated with improved survival [6]. Pelvic angiography and subsequent embolisation is a safe, rapid, and effective technique for patients with pelvic fracture-related arterial haemorrhage in both haemodynamically stable and unstable patients [7–9]. Transarterial embolisation (TAE) is the mainstay of tr
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