Rectus sheath hematoma: conservative, endovascular or surgical treatment? A single-center artificial neural network analysis.
Purpose: Rectum sheath hematoma (RSH) is a rare and often misdiagnosed disease. We aimed to determine outcomes of patients affected by RSH and identify variables associated with the need of prompt intervention. Methods: Patients diagnosed with RSH during the period 2012–2020 were retrospectively ide...
| Publicado en: | European Journal of Trauma & Emergency Surgery Vol. 48; no. 3; pp. 2157 - 2165 |
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| Autores principales: | , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Springer Nature
Jun2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=157411516&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 157411516 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18639933 3C05 jtl: European Journal of Trauma & Emergency Surgery issn: 18639933 maglogo: N pubinfo: dt: Jun2022 vid: 48 iid: 3 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 157411516 154647902 157411516 157411516 10.1007/s00068-021-01854-2 157411516 ppf: 2157 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Rectus sheath hematoma: conservative, endovascular or surgical treatment? A single-center artificial neural network analysis. aug: au: Angeramo, Cristian A. Méndez, Patricio Eyheremendy, Eduardo P. Schlottmann, Francisco affil: Department of Surgery, Hospital Alemán of Buenos Aires, Av. Pueyrredon 1640, C1118AAT, Buenos Aires, Argentina sug: subj: Abdominal Pain Etiology Rectus Abdominis Muscles Pathology Hematoma Diagnosis Hematoma Surgery Endovascular Procedures Treatment Outcomes Neural Networks (Computer) Artificial Intelligence Human Male Female Adult Middle Age Aged Aged, 80 and Over Retrospective Design Tomography, X-Ray Computed Hematoma Etiology Iatrogenic Disease Complications Anticoagulants Therapeutic Use Embolization, Therapeutic Hematoma Complications Hematoma Mortality Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Male Female ab: Purpose: Rectum sheath hematoma (RSH) is a rare and often misdiagnosed disease. We aimed to determine outcomes of patients affected by RSH and identify variables associated with the need of prompt intervention. Methods: Patients diagnosed with RSH during the period 2012–2020 were retrospectively identified. Demographics, diagnostic, and therapeutic variables were evaluated. RSH was classified with computed tomography (CT) according to the Berna system. An artificial neural network (ANN) model including 12 variables was used to identify patients that might require a prompt endovascular or surgical treatment. Results: A total of 20 patients were included for analysis; mean age was 69 (35–98) years and 14 (70%) were females. Iatrogenic injury and forceful contraction of the abdominal wall were the leading causes of RSH. Eleven (55%) patients were anticoagulated or antiaggregated. There were 3 (15%) grade 1, 5 (25%) grade 2, and 12 (60%) grade 3 RSH; 6 (30%) were treated conservatively, 10 (50%) with artery embolization, and 4 (20%) with surgery. Overall morbidity was 45% and there was no mortality in the series. According to the ANN, patients at high risk of requiring an invasive treatment were those with active extravasation on CT angiography, Berna grade III, age ≥ 65 years, hemodynamic instability, chronic use of corticosteroids, hematoma volume ≥ 1000 mL, and/or transfusion of ≥ 4 units of red blood cells. Conclusion: Conservative treatment might be effective in selected patients with RSH. Our artificial neural network analysis might help selecting patients who require endovascular or surgical treatment. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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