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Delayed embolization associated with increased mortality in pelvic fracture with hemodynamic stability at hospital arrival
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 associati...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8094563/ https://www.ncbi.nlm.nih.gov/pubmed/33941216 http://dx.doi.org/10.1186/s13017-021-00366-z |
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author | Aoki, Makoto Abe, Toshikazu Matsumoto, Shokei Hagiwara, Shuichi Saitoh, Daizoh Oshima, Kiyohiro |
author_facet | Aoki, Makoto Abe, Toshikazu Matsumoto, Shokei Hagiwara, Shuichi Saitoh, Daizoh Oshima, Kiyohiro |
author_sort | Aoki, Makoto |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-8094563 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-80945632021-05-05 Delayed embolization associated with increased mortality in pelvic fracture with hemodynamic stability at hospital arrival Aoki, Makoto Abe, Toshikazu Matsumoto, Shokei Hagiwara, Shuichi Saitoh, Daizoh Oshima, Kiyohiro World J Emerg Surg Research Article 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. BioMed Central 2021-05-03 /pmc/articles/PMC8094563/ /pubmed/33941216 http://dx.doi.org/10.1186/s13017-021-00366-z Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Aoki, Makoto Abe, Toshikazu Matsumoto, Shokei Hagiwara, Shuichi Saitoh, Daizoh Oshima, Kiyohiro Delayed embolization associated with increased mortality in pelvic fracture with hemodynamic stability at hospital arrival |
title | Delayed embolization associated with increased mortality in pelvic fracture with hemodynamic stability at hospital arrival |
title_full | Delayed embolization associated with increased mortality in pelvic fracture with hemodynamic stability at hospital arrival |
title_fullStr | Delayed embolization associated with increased mortality in pelvic fracture with hemodynamic stability at hospital arrival |
title_full_unstemmed | Delayed embolization associated with increased mortality in pelvic fracture with hemodynamic stability at hospital arrival |
title_short | Delayed embolization associated with increased mortality in pelvic fracture with hemodynamic stability at hospital arrival |
title_sort | delayed embolization associated with increased mortality in pelvic fracture with hemodynamic stability at hospital arrival |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8094563/ https://www.ncbi.nlm.nih.gov/pubmed/33941216 http://dx.doi.org/10.1186/s13017-021-00366-z |
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