Predictability of successful transarterial embolization in pelvic fracture bleeding based on patient initial presentation

2018 ◽  
Vol 07 ◽  
Author(s):  
Cheng-Cheng Tung
Keyword(s):  
Pelvic Fracture ◽  
Transarterial Embolization ◽  
Initial Presentation

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

2021 ◽  
Author(s):  
Hohyun Kim ◽  
Chang Ho Jeon ◽  
Jae Hun Kim ◽  
Hoon Kwon ◽  
Chang Won Kim ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Pelvic Fracture ◽  
Proportional Hazards ◽  
Transarterial Embolization ◽  
Negative Relationship ◽  
Cox Proportional Hazards ◽  
Red Blood Cell Transfusion ◽  
Trauma Patients ◽  
Regression Analyses ◽  
Arterial Bleeding

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.

scholarly journals Relationship Between Door-to-Embolization Time and Clinical Outcomes After Transarterial Embolization in Trauma Patients With Severe Pelvic Fracture

2020 ◽  
Author(s):  
Hohyun Kim ◽  
Chang Ho Jeon ◽  
Jae Hun Kim ◽  
Hoon Kwon ◽  
Chang Won Kim ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Pelvic Fracture ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Transarterial Embolization ◽  
Negative Relationship ◽  
Red Blood Cell Transfusion ◽  
Trauma Patients ◽  
Regression Analyses ◽  
Arterial Bleeding

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 204 patients treated with TAE. The relationships between DTE time and patients’ outcomes were evaluated. Multivariate binomial logistic regression analyses, multivariate linear regression analyses, and multivariate 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, 123–186). The mortality rates at 7 and 28 days and overall were 8.3%, 13.7%, and 15.7%, respectively. DTE time served as an independent risk factor for mortality at 7 and 28 days (adjusted odds ratio = 1.62, 95% confidence interval [CI] = 1.14–2.30, p = 0.007; adjusted odds ratio = 1.48, CI = 1.05–2.07, p = 0.023, respectively). In multivariate Cox proportional hazards regression analyses, the adjusted hazard ratio of DTE time for mortality at 28 days was 1.28 (CI = 1.08–1.30, p = 0.005). 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.Conclusions: Shorter DTE time was associated with better survival at 7 and 28 days, as well as other clinical outcomes, in patients with severe 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.

112: Pelvic Fracture Urethral Distraction Defect Perineal Anastomotic Repair: 20-Year Experience

2007 ◽  
Vol 177 (4S) ◽  
pp. 39-39
Author(s):  
Ramon Virasoro ◽  
Michael B. Williams ◽  
Jennifer L. Bepple ◽  
Jessica Drummond ◽  
Gerald H. Jordan
Keyword(s):  
Pelvic Fracture

330: Sexual and Excretory Dysfunction One Year after Pelvic Fracture

2005 ◽  
Vol 173 (4S) ◽  
pp. 91-91
Author(s):  
Jonathan L. Wright ◽  
Hunter B. Wessells ◽  
Avery B. Nathens ◽  
Ellen MacKenzie ◽  
Frederick P. Rivara
Keyword(s):  
Pelvic Fracture ◽  
One Year

Transarterial embolization of peripheral arteriovenous malformations with ethylenevinyl alcohol copolymer - feasibility, technical outcomes, and clinical outcomes

VASA ◽  
2016 ◽  
Vol 45 (6) ◽  
pp. 497-504 ◽  
Author(s):  
Tom De Beule ◽  
Jan Vranckx ◽  
Peter Verhamme ◽  
Veerle Labarque ◽  
Marie-Anne Morren ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Clinical Improvement ◽  
Arteriovenous Malformations ◽  
Clinical Success ◽  
Transarterial Embolization ◽  
Recurrent Bleeding ◽  
Complete Disappearance ◽  
Ethylene Vinyl Alcohol ◽  
Initial Symptoms

Abstract. Background: The technical and clinical outcomes of catheter-directed embolization for peripheral arteriovenous malformations (AVM) using Onyx® (ethylene-vinyl alcohol copolymer) are not well documented. The purpose of this study was to retrospectively assess the safety, technical outcomes and clinical outcomes of catheter-directed Onyx® embolisation for the treatment of symptomatic peripheral AVMs. Patients and methods: Demographics, (pre-)interventional clinical and radiological data were assessed. Follow-up was based on hospital medical records and telephone calls to the patients’ general practitioners. Radiological success was defined as complete angiographic eradication of the peripheral AVM nidus. Clinical success was defined as major clinical improvement or complete disappearance of the initial symptoms. Results: 25 procedures were performed in 22 patients. The principal indications for treatment were pain (n = 10), limb swelling (n = 6), recurrent bleeding (n = 2), tinnitus (n = 3), and exertional dyspnoea (n = 1). Complete radiological success was obtained in eight patients (36 %); near-complete eradication of the nidus was achieved in the remaining 14 patients. Adjunctive embolic agents were used in nine patients (41 %). Clinical success was observed in 18 patients (82%). Major complications were reported in two patients (9 %). During follow-up, seven patients (32 %) presented with symptom recurrence, which required additional therapy in three patients. Conclusions: Catheter-directed embolisation of peripheral AVMs with Onyx® resulted in major clinical improvement or complete disappearance of symptoms in the vast majority of patients, although complete angiographic exclusion of the AVMs occurred in only a minority of patients.

Myasthenic symptoms: From initial presentation to diagnosis

2012 ◽  
Vol 43 (02) ◽  
Author(s):  
H Trippe ◽  
M Munteanu ◽  
F Stehling ◽  
U Mellies ◽  
R Heller ◽  
...  
Keyword(s):  
Initial Presentation
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