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Journal of Trauma and Injury 2012;25(4):166-171.
Prognostic Factors in Patients Who Performed Angiographic Embolization for the Bleeding from Injury of the Intraabdominal Organ and Pelvic Area
Jin Ho Lee, Ji Young Jang, Hong jin Shim, Jae Gil Lee
Department of Surgery, Yonsei University, College of Medicine, Seoul, Korea. jakii@yuhs.ac
외상성 복부 장기 손상 및 골반 손상에 의한 혈복강으로
동맥 색전술을 시행 받은 환자에서 예후 인자
이진호∙장지영∙심홍진∙이재길
연세대학교 의과대학 외과학교실
Received: 18 September 2012   • Revised: 20 September 2012   • Accepted: 23 October 2012
Abstract
PURPOSE
In patients with traumatic hemoperitoneum or pelvic bone fracture who underwent angiography and embolization, we want to find the prognostic factors related with mortality.
METHODS
Patients(333 patients) who visited our hospital with traumatic injury from March 2008 to April 2012 were included in this study. Only 37 patients with traumatic hemoperitoneum or pelvic bone fracture underwent angiography and embolization. A retrospective review was conducted, and Glasgow coma scale (GCS), Revised trauma score (RTS), Injury severity score (ISS), initial laboratory finding and time interval, the amount of transfusion from the arrival at the ER to the start of embolization, and the vital signs before and after procedure were checked. Stastical analysis was conducted using the Chi square and Mann-Whitney U test.
RESULTS
In univariate analysis, the amount of transfusion, the base deficit before procedure, the systolic blood pressure before and after the procedure, the GCS, the RTS and the ISS were significantly associated with prognosis. In the multivariate analysis, the ISS and the base deficit had significant association with prognosis. Of the 37 patients who underwent angiography and embolization, 31 patients needed not additional procedure (Group A) while the other 6 patients needed an additional procedure (Group B). After procedure, a statistically significant higher blood pressure was observed in Group A than in Group B. As to the difference in blood pressure before and after the procedure, a statistically significant decrease in systolic blood pressure was observed in Group B, but an increase was observed in Group A.
CONCLUSION
In traumatic hemoperitoneum or pelvic bone fracture patients who underwent angiography and embolization, GCS, ISS, RTS, transfusion amount before the procedure, initial base deficit and systolic blood pressure were factors related to mortality. When patients who underwent angiography and embolization only were compared with patients who underwent re-embolization or additional procedure after the first embolization, an increase in systolic blood pressure after embolization was a prognostic factor for successful control of bleeding.
Key Words: Hemoperitoneum; Intraabdominal injury; Pelvic injury; Embolization; Prognosis
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