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

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 fr...

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Published in:European Journal of Trauma & Emergency Surgery Vol. 48; no. 3; pp. 1929 - 1939
Main Authors: Kim, Hohyun, Jeon, Chang Ho, Kim, Jae Hun, Kwon, Hoon, Kim, Chang Won, Kim, Gil Hwan, Lee, Chan Kyu, Lee, Sang Bong, Jang, Jae Hoon, Kim, Seon Hee, Park, Chan Yong, Yeom, Seok Ran
Format: algorithm research tables/charts Journal Article
Published: Springer Nature Jun2022
Online Access:View this record in EBSCOhost
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      dt: Jun2022
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00068-021-01601-7
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        atl: Relationship between door-to-embolization time and clinical outcomes after transarterial embolization in trauma patients with complex pelvic fracture.
      aug:
        au:
          Kim, Hohyun
          Jeon, Chang Ho
          Kim, Jae Hun
          Kwon, Hoon
          Kim, Chang Won
          Kim, Gil Hwan
          Lee, Chan Kyu
          Lee, Sang Bong
          Jang, Jae Hoon
          Kim, Seon Hee
          Park, Chan Yong
          Yeom, Seok Ran
        affil: Department of Trauma Surgery and Surgical Critical Care, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, 49241, Busan, Korea
      sug:
        subj:
          Pelvic Fractures Surgery
          Multiple Trauma Surgery
          Pelvic Fractures Prognosis
          Multiple Trauma Prognosis
          Embolization, Therapeutic
          Treatment Delay
          Treatment Outcomes Evaluation
          Time Factors
          Human
          Emergency Patients
          Retrospective Design
          Record Review
          Surgical Patients
          Multiple Logistic Regression
          Multiple Linear Regression
          Cox Proportional Hazards Model
          Pelvic Fractures Mortality
          Descriptive Statistics
          Risk Assessment
          Odds Ratio
          Confidence Intervals
          Survival Analysis
      ab: 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.
      pubtype: Academic Journal
      doctype:
        algorithm
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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