RESUMEN
PURPOSE: To evaluate patient and procedure-related factors contributing to the radiation dose, cumulative fluoroscopy time (CFT), and procedural time (PT) of Arterial Embolization (AE) for suspected active bleeding. METHODS: Data on patients who underwent AE for suspected bleeding was retrospectively gathered between January 2019 and April 2022. Data collected included the dependent variables consisting of dose-area product (DAP), CFT, PT, and independent variables consisting of demographic, bleeding-specific, and procedure-specific parameters. All statistical computations were performed in SPSS statistics. The alpha value was set at 0.05. RESULTS: Data from a total of 148 AE were collected with an average patient's age of 61.06 ± 21.57 years. Higher DAP was independently associated with male sex (p < 0.002), age ranges between 46 and 65 years (p = 0.019) and > 66 years (p = 0.027), BMI above 30 (p = 0.016), attending with less than 10 years of experience (p = 0.01), and bleeding in the abdomen and pelvis (p = 0.027). Longer CFT was independently associated with attending with less than 10 years of experience (p < 0.001), having 2 (p = 0.004) or > 3 (p = 0.005) foci of bleed, and age between 46 and 65 years (p = 0.007) and ≥ 66 years (p = 0.017). Longer PT was independently associated with attending with less than 10 years of experience (p < 0.001) and having 2 (p = 0.014) or > 3 (p = 0.005) foci of bleed. CONCLUSION: The interventionist experience influenced radiation dose, CFT and PT. Dose was also affected by patients' sex, age, BMI, as well as bleeding location. CFT was also affected by patients' age, and both CFT and PT were also affected by the number of bleeding foci. These findings highlight the multifaceted factors that affect radiation dose and procedural time, emphasizing the importance of interventionist expertise, patient's age, sex, BMI, location and number of bleeds.
RESUMEN
PURPOSE: (1) Describe imaging utilization and findings within two weeks of the 2020 Beirut blast according to the mechanism of injury, (2) determine the appropriate imaging modality per organ/system, and (3) describe changes in the workflow of a radiology department to deal with massive crises. MATERIALS AND METHODS: Two hundred sixty patients presented to the largest emergency department in Beirut and underwent imaging within 2 weeks of the blast. In this retrospective study, patients were divided into early (1) and late (2) imaging groups. Patients' demographic, outcome, type and time of imaging studies, body parts imaged, and mechanism and types of injuries were documented. RESULTS: Two hundred five patients in group 1 underwent 502 and 55 patients in group 2 underwent 145 imaging studies. Tertiary blast injuries from direct impact and falling objects were the most common type of injuries followed by secondary (shrapnel) injuries. Both types of injuries affected mostly the head and neck and upper extremities. Plain radiographs were adequate for the extremities and CT for the head and neck. A regularly updated and practiced emergency plan is essential to mobilize staff and equipment and efficiently deliver radiology services during crises. CONCLUSION: Because the powerful Beirut blast occurred at the port located in the periphery of the city, most injuries seen on imaging were of the upper extremities and head and neck caused by the severe blast wind or penetrating shrapnel and resulted from people using their arms to protect their heads and bodies from direct impact and falling objects.