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- Title
Early experience with resuscitative endovascular balloon occlusion of the aorta for unstable pelvic fractures in the Republic of Korea: a multi-institutional study.
- Authors
Kim, Dong Hun; Moon, Jonghwan; Chang, Sung Wook; Kang, Byung Hee
- Abstract
Purpose: Recently, trauma centers in the Republic of Korea introduced resuscitative endovascular balloon occlusion of the aorta (REBOA) for application in severe pelvic fracture cases. This study aimed to determine the efficacy of REBOA and its associated factors in enhancing survival. Methods: Data from patients with severe pelvic injuries at two regional trauma centers from 2016 to 2020 were retrospectively reviewed. Patients were dichotomized into REBOA and no-REBOA groups, and patient characteristics and clinical outcomes were compared using 1:1 propensity score matching. Additional survival-based analysis was performed in the REBOA group. Results: REBOA was performed in 42 of the 174 patients with pelvic fractures. As patients in the REBOA group had more severe injuries than did patients in the no-REBOA group, 1:1 propensity score matching was performed to adjust for severity. After matching, 24 patients were included in each group and mortality was not significantly different (REBOA 62.5% vs. no-REBOA 41.7%, P = 0.149). Kaplan–Meier analysis revealed no significant differences in mortality between the two matched groups (log-rank test, P = 0.408). Among the 42 patients treated with REBOA, 14 survived. Shorter REBOA duration (63 [40–93] vs. 166 [67–193] min, P = 0.015) and higher systolic blood pressure before REBOA (65 [58–76] vs. 54 [49–69] mmHg, P = 0.035) were associated with better survival. Conclusions: The effectiveness of REBOA has not been definitively established; however, it was not associated with increased mortality in this study. Additional studies are required to better understand how REBOA can be effectively used for treatment.
- Subjects
SOUTH Korea; AORTA surgery; PELVIC fractures; LOG-rank test; TRAUMA centers; RETROSPECTIVE studies; FISHER exact test; MANN Whitney U Test; BALLOON occlusion; TREATMENT effectiveness; T-test (Statistics); SURVIVAL analysis (Biometry); DESCRIPTIVE statistics; KAPLAN-Meier estimator; CHI-squared test; ENDOVASCULAR surgery; DATA analysis software
- Publication
European Journal of Trauma & Emergency Surgery, 2023, Vol 49, Issue 6, p2495
- ISSN
1863-9933
- Publication type
Article
- DOI
10.1007/s00068-023-02293-x