Resuscitative endovascular balloon occlusion of the aorta (REBOA) in penetrating abdominal vascular injuries is associated with worse outcomes.

IF 2.7 3区医学 Q1 SURGERY American journal of surgery Pub Date : 2024-11-28 DOI:10.1016/j.amjsurg.2024.116122

Negar Nekooei, Wei Huang, Delbrynth Mitchao, Subarna Biswas, Anaar Siletz, Demetrios Demetriades

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引用次数: 0

Abstract

Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) may benefit patients with severe subdiaphragmatic traumatic hemorrhage. This study compares outcomes in patients with penetrating abdominal vascular injury treated with REBOA versus those managed without REBOA.

Methods: Using the Trauma Quality Improvement Program (TQIP) database, we identified adult patients with penetrating abdominal vascular injury from 2017 to 2022. Propensity scores matched REBOA patients 1:3 with non-REBOA patients. The primary outcome was in-hospital mortality, with secondary outcomes including 24-h mortality, transfusion needs, and complications such as acute kidney injury (AKI), deep vein thrombosis (DVT), pulmonary embolism (PE), lower extremity compartment syndrome, fasciotomy, amputation, and femoral artery repair.

Results: Two hundred ninety-three REBOA patients were matched with 879 non-REBOA patients. REBOA patients had higher in-hospital mortality (46.8 % vs 36.3 %, p = 0.002), packed-red blood cell (PRBC) transfusion requirements within 4 h (median 15.3 vs 8.2, p < 0.001), AKI (8.5 % vs 4.7 %, p = 0.013), fasciotomy (6.5 % vs 3.6 %, p = 0.039), amputation (3.4 % vs 1.4 %, p = 0.025), and femoral artery repair (3.4 % vs 0.6 %, p < 0.001). In a subgroup analysis of patients without severe extra-abdominal injuries, REBOA was associated with higher in-hospital mortality (49.7 % vs. 38.2 %, p = 0.013) and increased packed red blood cell (PRBC) transfusion requirements (median 14.1 vs. 8.3 units, p < 0.001).

Conclusions: In penetrating abdominal vascular injuries, REBOA was associated with worse outcomes.

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.