Dataset Information

Relationship between door-to-embolization time and clinical outcomes after transarterial embolization in trauma patients with complex pelvic fracture.

ABSTRACT:

Background

While transarterial embolization (TAE) is an effective way to control arterial bleeding associated with pelvic fracture, the clinical outcomes according to door-to-embolization (DTE) time are unclear. This study investigated how DTE time affects outcomes in patients with severe pelvic fracture.

Methods

Using a trauma database between November 1, 2015 and December 31, 2019, trauma patients undergoing TAE were retrospectively reviewed. The final study population included 192 patients treated with TAE. The relationships between DTE time and patients' outcomes were evaluated. Multiple binomial logistic regression analyses, multiple linear regression analyses, and Cox hazard proportional regression analyses were performed to estimate the impacts of DTE time on clinical outcomes.

Results

The median DTE time was 150 min (interquartile range, 121-184). The mortality rates in the first 24 h and overall were 3.7% and 14.6%, respectively. DTE time served as an independent risk factor for mortality in the first 24 h (adjusted odds ratio = 2.00, 95% confidence interval [CI] = 1.20-3.34, p = 0.008). In Cox proportional hazards regression analyses, the adjusted hazard ratio of DTE time for mortality at 28 days was 1.24 (95% CI = 1.04-1.47, p = 0.014). In addition, there was a positive relationship between DTE time and requirement for packed red blood cell transfusion during the initial 24 h and a negative relationship between DTE time and ICU-free days to day 28.

Conclusion

Shorter DTE time was associated with better survival in the first 24 h, as well as other clinical outcomes, in patients with complex pelvic fracture who underwent TAE. Efforts to minimize DTE time are recommended to improve the clinical outcomes in patients with pelvic fracture treated with TAE.

SUBMITTER: Kim H

PROVIDER: S-EPMC9192384 | biostudies-literature | 2022 Jun

REPOSITORIES: biostudies-literature

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Publications

Relationship between door-to-embolization time and clinical outcomes after transarterial embolization in trauma patients with complex pelvic fracture.

Kim Hohyun H Jeon Chang Ho CH Kim Jae Hun JH Kwon Hoon H Kim Chang Won CW Kim Gil Hwan GH Lee Chan Kyu CK Lee Sang Bong SB Jang Jae Hoon JH Kim Seon Hee SH Park Chan Yong CY Yeom Seok Ran SR

European journal of trauma and emergency surgery : official publication of the European Trauma Society 20210201 3

<h4>Background</h4>While transarterial embolization (TAE) is an effective way to control arterial bleeding associated with pelvic fracture, the clinical outcomes according to door-to-embolization (DTE) time are unclear. This study investigated how DTE time affects outcomes in patients with severe pelvic fracture.<h4>Methods</h4>Using a trauma database between November 1, 2015 and December 31, 2019, trauma patients undergoing TAE were retrospectively reviewed. The final study population included ...[more]

PMID: 33523237

Similar Datasets

Project description:BackgroundIncreasing life expectancy has led to higher incidence of fragility fractures of the pelvis. These demographic changes may have a direct impact on fracture patterns. The goal of this study was (1) to evaluate demographical trends in patients with pelvic ring injuries at a tertiary Swiss trauma center and (2) to analyze the influence on fracture patterns.MethodsWe performed a retrospective cross-sectional study including 958 patients (mean ± SD age, 57 ± 21 years; 48% women) with a pelvic ring injury between 2007 and 2017. Fractures were classified according to Tile, Young and Burgess or Rommens and Hofmann (fragility fractures) using conventional and computer tomography imaging. Low-energy fractures were defined as fractures resulting from fall from standing height or less. Fracture classifications, age, sex, Injury Severity Score, and trauma mechanism were compared using analysis of variance or χ2 test. Cluster analysis was performed to identify groups with similarities in fracture patterns and demographic parameters.ResultsFrom 2007 to 2017, the frequency of pelvic ring injuries increased by 115% (increase per decade), and mean age increased by 15% (p = 0.031). A trimodal age distribution was found; highest increase for fractures occurred in the older (265%) patient group. Low-energy fracture was the most common trauma mechanism (43% of all fractures, an increase of 249%). Changes in fracture pattern showed a disproportioned increase of lateral compression (LC) fractures (LC type 1 in 64%) or partially stable fracture (B2, with 39%). In patient older than 65 years, the strongest increase was found for nondisplaced posterior fractures with an overall prevalence of 62%. Five clusters were found with the most frequent cluster representing older female patients with low-energy fracture (LC, Tile type B) in 30%.ConclusionThe current results corroborate the trend of increasing frequency of fragility fractures in an aging society. The demographic shift has a direct impact on fracture pattern with a disproportionate increase in partially stable compression fracture of the pelvis.Level of evidencePrognostic/Epidemiologic, Level III.

Dataset Information

Relationship between door-to-embolization time and clinical outcomes after transarterial embolization in trauma patients with complex pelvic fracture.

Background

Methods

Results

Conclusion

Publications

Relationship between door-to-embolization time and clinical outcomes after transarterial embolization in trauma patients with complex pelvic fracture.

Similar Datasets

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