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World Journal of Emergency Surgery

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Open Access 01-12-2019 | Research article

Hemostasis as soon as possible? The role of the time to angioembolization in the management of pelvic fracture

Authors: Chang-Hua Chou, Yu-Tung Wu, Chih-Yuan Fu, Chien-Hung Liao, Shang-Yu Wang, Francesco Bajani, Chi-Hsun Hsieh

Published in: World Journal of Emergency Surgery | Issue 1/2019

Abstract

Introduction

While transcatheter arterial embolization (TAE) is an effective way to control arterial bleeding associated with pelvic fracture, delayed TAE may increase mortality risk. The purpose of the current study was to determine how time to TAE affects outcomes in patients with pelvic fracture in the emergency department.

Methods

From January 2014 to December 2016, the trauma registry and medical records of patients with pelvic fracture who underwent TAE were retrospectively reviewed. The relationship between the time to TAE and patient outcomes was evaluated. The characteristics of surviving and deceased patients were also compared to search for prognostic factors affecting survival.

Results

Eighty-four patients were enrolled in the current study. Among patients with pelvic fracture who underwent TAE, the overall mortality rate was 16.7%. There were positive relationships between the time to TAE and the requirement for blood transfusion and between the time to TAE and intensive care unit (ICU) length of stay (LOS). Nonsurviving patients were significantly older (57.4 ± 23.3 vs. 42.7 ± 19.3 years old, p = 0.014) and had higher injury severity scores (ISSs) (36.4 ± 11.9 vs. 23.9 ± 10.9, p < 0.001) than were observed in surviving patients. There was no significant difference in the time to TAE between nonsurviving and surviving patients (76.9 ± 47.9 vs. 59.0 ± 29.3 min, p = 0.068). The multivariate logistic regression analysis showed that ISS and age served as independent risk factors for mortality. Every one unit increase in ISS or age resulted in a 1.154- or 1.140-fold increase in mortality, respectively (p = 0.033 and 0.005, respectively). However, the time to TAE serves as an independent factor for ICU LOS (p = 0.015).

Conclusion

In pelvic fracture patients who require TAE for hemostasis, longer time to TAE may cause harm. An early hemorrhage control is suggested.

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Title: Hemostasis as soon as possible? The role of the time to angioembolization in the management of pelvic fracture
Authors: Chang-Hua Chou
Yu-Tung Wu
Chih-Yuan Fu
Chien-Hung Liao
Shang-Yu Wang
Francesco Bajani
Chi-Hsun Hsieh
Publication date: 01-12-2019
Publisher: BioMed Central
Published in: World Journal of Emergency Surgery / Issue 1/2019
Electronic ISSN: 1749-7922
DOI: https://doi.org/10.1186/s13017-019-0248-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Hemostasis as soon as possible? The role of the time to angioembolization in the management of pelvic fracture

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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