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Resuscitative Endovascular Balloon Occlusion of The Aorta (REBOA) And Mortality in Hemorrhagic Shock Associated with Severe Pelvic Fracture: a National Data Analysis.
Ahmed, Nasim; Kuo, Yen-Hong.
Afiliación
  • Ahmed N; Division of Trauma & Surgical Critical Care, Jersey Shore University Medical Center, Neptune, NJ, USA. Nasim.Ahmed@hmhn.org.
  • Kuo YH; Hackensack Meridian School of Medicine, Nutley, NJ, USA. Nasim.Ahmed@hmhn.org.
BMC Emerg Med ; 24(1): 104, 2024 Jun 24.
Article en En | MEDLINE | ID: mdl-38910235
ABSTRACT

BACKGROUND:

The purpose of the study was to evaluate the mortality of patients who received Resuscitative Endovascular Balloon Occlusion of The Aorta (REBOA) in severe pelvic fracture with hemorrhagic shock.

METHODS:

The American College of Surgeon Trauma Quality Improvement Program (ACS-TQIP) database for the calendar years 2017-2019 was accessed for the study. The study included all patients aged 15 years and older who sustained severe pelvic fractures, defined as an injury with an abbreviated injury scale (AIS) score of ≥ 3, and who presented with the lowest systolic blood pressure (SBP) of < 90 mmHg. Patients with severe brain injury were excluded from the study. Propensity score matching was used to compare the patients who received REBOA with similar characteristics to patients who did not receive REBOA.

RESULTS:

Out of 3,186 patients who qualified for the study, 35(1.1%) patients received REBOA for an ongoing hemorrhagic shock with severe pelvic fracture. The propensity matching created 35 pairs of patients. The pair-matched analysis showed no significant differences between the group who received REBOA and the group that did not receive REBOA regarding patients' demography, injury severity, severity of pelvic fractures, lowest blood pressure at initial assessment and laparotomies. There was no significant difference found between REBOA versus no REBOA group in overall in-hospital mortality (34.3% vs. 28.6, P = 0.789).

CONCLUSION:

Our study did not identify any mortality advantage in patients who received REBOA in hemorrhagic shock associated with severe pelvic fracture compared to a similar cohort of patients who did not receive REBOA. A larger sample size prospective study is needed to validate our results. CASE-CONTROL RETROSPECTIVE STUDY Level of Evidence IV.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Huesos Pélvicos / Resucitación / Choque Hemorrágico / Oclusión con Balón / Fracturas Óseas / Puntaje de Propensión Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: BMC Emerg Med Asunto de la revista: MEDICINA DE EMERGENCIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Huesos Pélvicos / Resucitación / Choque Hemorrágico / Oclusión con Balón / Fracturas Óseas / Puntaje de Propensión Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: BMC Emerg Med Asunto de la revista: MEDICINA DE EMERGENCIA Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido