Angioembolization versus preperitoneal packing for severe pelvic fractures: A propensity matched analysis - 06/03/23
, Kazuhide Matsushima b, Shokei Matsumoto cAbstract |
Background |
Whether AE or PPP would be associated with survival among hemodynamically unstable pelvic fracture remains controversial.
Study design |
This is a retrospective cohort study using the American College of Surgeons Trauma Quality Improvement Program database from 2016 to 2018. Patients >16 years with a severe pelvic fracture (abbreviated injury scale 3–5) who underwent AE or PPP were recruited. The primary outcome was in-hospital survival. Data were evaluated using a propensity-score matching (PSM) analysis.
Results |
A total of 1123 patients met our inclusion criteria. Of these, AE and PPP were performed in 964 (85.8%) and 159 (14.2%) patients, respectively. Concomitant hemorrhage control laparotomy was performed in 25.6% and 82.4% of AE and PPP patients, respectively. In 220 PSM patients, the mortality rate between AE and PPP groups was not significantly different (30.9% vs. 38.2%, P = 0.321).
Conclusions |
Though patients’ characteristics differed between AE and PPP groups, comparable propensity-matched patients with severe pelvic fractures showed no significant difference in in-hospital survival. PPP was more likely to be selected for severe pelvic fractures necessitating laparotomy.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Highlights |
• | Propensity-matched patients with severe pelvic fractures showed no significant difference in in-hospital survival between angioembolization and preperitoneal packing (PPP) |
• | PPP was more likely to be selected for severe pelvic fractures necessitating laparotomy |
• | Hemorrhagic control strategy for severe pelvic fracture should be individualized based on each patients' physiologies and anatomical features, and available resources |
Keywords : Pelvic fracture, Angioembolization, Preperitoneal packing, Propensity-score matching, In-hospital mortality
Plan
Vol 225 - N° 2
P. 408-413 - février 2023 Retour au numéro
Article précédent
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