scholarly journals Comparison between laparotomy first versus angiographic embolization first in patients with pelvic fracture and hemoperitoneum: a nationwide observational study from the Japan Trauma Data Bank

2013 ◽  
Vol 21 (1) ◽  
pp. 82 ◽  
Author(s):  
Morihiro Katsura ◽  
Shin Yamazaki ◽  
Shingo Fukuma ◽  
Kazuhide Matsushima ◽  
Toshimitsu Yamashiro ◽  
...  
Keyword(s):  
Observational Study ◽  
Pelvic Fracture ◽  
Data Bank ◽  
Angiographic Embolization ◽  
Nationwide Observational Study ◽  
Japan Trauma Data Bank

scholarly journals Delayed embolization associated with increased mortality in pelvic fracture with hemodynamic stability at hospital arrival

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Makoto Aoki ◽  
Toshikazu Abe ◽  
Shokei Matsumoto ◽  
Shuichi Hagiwara ◽  
Daizoh Saitoh ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Pelvic Fracture ◽  
Injury Severity ◽  
Data Bank ◽  
Hemodynamic Stability ◽  
Hospital Arrival ◽  
Pelvic Embolization ◽  
Arterial Hemorrhage ◽  
Using Data ◽  
Japan Trauma Data Bank

Abstract Background Embolization is widely used for controlling arterial hemorrhage associated with pelvic fracture. However, the effect of a delay in embolization among hemodynamically stable patients at hospital arrival with a pelvic fracture is unknown. Therefore, our aim was to investigate the association between the time to embolization and mortality in hemodynamically stable patients at hospital arrival with a pelvic fracture. Methods A multicenter, retrospective cohort study was undertaken using data from the Japan Trauma Data Bank between 2004 and 2018. Hemodynamically, stable patients with a pelvic fracture who underwent an embolization within 3 h were divided into six groups of 30-min blocks of time until pelvic embolization (0–30, 30–60, 60–90, 90–120, 120–150, and 150–180 min). We compared the adjusted 30-day mortality rate according to time to embolization. Results We studied 620 hemodynamically stable patients with a pelvic fracture who underwent pelvic embolization within 3 h of hemorrhage. The median age was 68 (48–79) years and 55% were male. The median injury severity score was 26 (18–38). Thirty-day mortality was 8.9% (55/620) and 24-h mortality was 4.2% (26/619). A Cochran–Armitage test showed that a 30-min delay for embolization was associated with increased 30-day (p = 0.0186) and 24-hour (p = 0.033) mortality. Mortality within 0–30 min to embolization was 0%. The adjusted 30-day mortality rate increased with delayed embolization and was up to 17.0% (10.2–23.9) for the 150–180 min group. Conclusion Delayed embolization was associated with increased mortality in pelvic fracture with hemodynamic stability at hospital arrival. When you decide to embolize pelvic fracture patients, the earlier embolization may be desirable to promote improved survival regardless of hemodynamics.

scholarly journals Delayed Embolization Associated With Increased Mortality in Patients With Hemodynamically Stable Pelvic Fracture

2021 ◽  
Author(s):  
Makoto Aoki ◽  
Toshikazu Abe ◽  
Shokei Matsumoto ◽  
Shuichi Hagiwara ◽  
Daizoh Saitoh ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Pelvic Fracture ◽  
Early Identification ◽  
Retrospective Cohort ◽  
Injury Severity ◽  
Data Bank ◽  
Pelvic Embolization ◽  
Arterial Hemorrhage ◽  
Using Data ◽  
Japan Trauma Data Bank

Abstract Background: Embolization is widely used for controlling arterial hemorrhage associated with pelvic fracture. However, the effect of a delay in embolization among hemodynamically stable patients with pelvic fracture is unknown. Therefore, our aim was to investigate the association between the time to embolization and mortality in hemodynamically stable patients with a pelvic fracture.Methods: A multicenter, retrospective cohort study was undertaken using data from the Japan Trauma Data Bank from between 2004 and 2018. Hemodynamically stable patients with pelvic fracture who underwent an embolization within 3 h were divided into six groups of 30-min blocks of time until pelvic embolization (0–30, 30–60, 60–90, 90–120, 120–150, and 150–180 min). We compared the adjusted 30-day mortality rate according to time to embolization. Results: We studied 620 hemodynamically stable patients with a pelvic fracture who underwent pelvic embolization within 3 h of hemorrhage. The median age was 68 (48–79) years and 55% were male. The median injury severity score was 26 (18–38). Thirty-day mortality was 8.9% (55/620) and 24-hour mortality was 4.2% (26/619). A Cochran–Armitage test showed that a 30-min delay for embolization was associated with increased 30-day (p = 0.0186) and 24-hour (p = 0.033) mortality. Mortality within 0–30 min to embolization was 0%. The adjusted 30-day mortality rate increased with delayed embolization and was up to 17.0% (10.2–23.9) for the 150–180 min group. Conclusion: Delayed embolization was associated with increased mortality among hemodynamically stable patients with pelvic fracture. Early identification and embolization reduced mortality in such patients.

Sign in / Sign up

Export Citation Format

Share Document