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Which Pelvic Fractures Are Associated With Extravasation on Angiography?
Fierro, Nicole M; Dhillon, Navpreet K; Siletz, Anaar E; Muníz, Tobias; Barmparas, Galinos; Ley, Eric J; Hashim, Yassar M.
Afiliación
  • Fierro NM; Department of Surgery, 22494Cedars-Sinai Medical Center, Los Angeles, CA, USA.
  • Dhillon NK; Department of Surgery, 22494Cedars-Sinai Medical Center, Los Angeles, CA, USA.
  • Siletz AE; Department of Surgery, 22494Cedars-Sinai Medical Center, Los Angeles, CA, USA.
  • Muníz T; Department of Surgery, 22494Cedars-Sinai Medical Center, Los Angeles, CA, USA.
  • Barmparas G; Department of Surgery, 22494Cedars-Sinai Medical Center, Los Angeles, CA, USA.
  • Ley EJ; Department of Surgery, 22494Cedars-Sinai Medical Center, Los Angeles, CA, USA.
  • Hashim YM; Department of Surgery, 22494Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Am Surg ; 88(10): 2493-2498, 2022 Oct.
Article en En | MEDLINE | ID: mdl-35546075
BACKGROUND: Bleeding from pelvic fractures can result in a high mortality rate unless quickly triaged by the trauma surgeon. Upon presentation, pelvic radiography may identify fractures that require angiography with possible embolization. We sought to address which fracture patterns seen on initial x-ray are associated with extravasation on angiography. METHODS: Data from a single institution retrospective review were collected on trauma patients admitted from 2011 to 2018 with pelvic fractures that required angiography. These fractures were identified by initial pelvic x-ray in the trauma bay and include anteroposterior compression (APC), lateral compression (LC), vertical shear (VS), and combined mechanism (CM) fractures, which are graded by severity. Fracture patterns high risk for bleeding, defined as APC II, APC III, LC III, VS, and CM, were compared to low-risk fracture patterns. RESULTS: Of the patients reviewed, 28 underwent pelvic angiography, 16 (57%) of which had extravasation. The difference in the incidence of extravasation between high and low-risk fracture patterns did not reach significance (36% vs 79%, P = .05). When comparing patients with acetabular fractures to those without, there was a significantly higher rate of extravasation associated with acetabular fractures (89% vs 42%, P value = .04), which were more likely to occur with LC I fractures (56% vs 11%, P = .02). CONCLUSION: Our data suggest that traditional pelvic fracture patterns may overestimate the presence of extravasation. Acetabular fractures had a high rate of extravasation, suggesting that these fractures should be considered for early angiography with possible embolization when clinically warranted.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Huesos Pélvicos / Embolización Terapéutica / Fracturas Óseas Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Am Surg Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Huesos Pélvicos / Embolización Terapéutica / Fracturas Óseas Tipo de estudio: Etiology_studies / Observational_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Am Surg Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos