Resuscitative endovascular balloon occlusion of the aorta (REBOA) in the presence of associated severe traumatic brain injury: A propensity-score matched study - 26/09/24
, Morihiro Katsura a , Kyosuke Takahashi a , Kazuhide Matsushima a , Demetrios Demetriades a, ⁎ Abstract |
Background |
Experimental work suggested that resuscitative Endovascular Balloon Occlusion of the aorta (REBOA) preserves cerebral circulation in animal models of traumatic brain injury. No clinical work has evaluated the role of REBOA in the presence of associated severe traumatic brain injury (TBI). We investigated the impacts of REBOA on neurological and survival outcomes.
Methods |
Propensity-score matched study, using the American College of Surgeons Trauma Quality Improvement Program database. Patients with severe TBI patients (Abbreviated Injury Scale ≥3) receiving REBOA within 4 h from arrival were matched with similar patients not receiving REBOA. Neurological matching included head AIS, pupils, and midline shift. Clinical outcomes were compared between the two groups.
Results |
434 REBOA patients were matched with 859 patients without REBOA. Patients in the REBOA group had higher rates of in-hospital mortality (63.6 % vs 44.2 %, p < 0.001), severe sepsis (4.4 % vs 2.2 %, p = 0.029), acute kidney injury (10.1 % vs 6.6 %, p = 0.029), and withdrawal of life support (25.4 % vs 19.6 %, p = 0.020) despite of lower craniectomy/craniotomy rate (7.1 % vs 12.7 %, p < 0.002).
Conclusion |
In patients with severe TBI, REBOA use is associated with an increased risk of in-hospital mortality, AKI, and infectious complications.
Le texte complet de cet article est disponible en PDF.Graphical abstract |
Highlights |
• | REBOA use in presence of severe TBI patients. |
• | Worse mortality. |
• | Higher incidence of acute kideny injuries. |
• | Higher incidence of severe sepsis. |
• | Higher incidence of deep surgical site infections. |
Keywords : Traumatic brain injury, Resuscitative endovascular balloon occlusion of the aorta, Outcomes
Plan
Vol 237
Article 115798- novembre 2024 Retour au numéro
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