Resuscitative endovascular balloon occlusion of the aorta (REBOA): a population based gap analysis of trauma patients in England and Wales.
Emerg Med J
; 32(12): 926-32, 2015 Dec.
Article
em En
| MEDLINE
| ID: mdl-26598631
ABSTRACT
INTRODUCTION:
Non-compressible torso haemorrhage (NCTH) carries a high mortality in trauma as many patients exsanguinate prior to definitive haemorrhage control. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an adjunct that has the potential to bridge patients to definitive haemostasis. However, the proportion of trauma patients in whom REBOA may be utilised is unknown.METHODS:
We conducted a population based analysis of 2012-2013 Trauma Audit and Research Network (TARN) data. We identified the number of patients in whom REBOA may have been utilised, defined by an Abbreviated Injury Scale score ≥3 to abdominal solid organs, abdominal or pelvic vasculature, pelvic fracture with ring disruption or proximal traumatic lower limb amputation, together with a systolic blood pressure <90â mmâ Hg. Patients with non-compressible haemorrhage in the mediastinum, axilla, face or neck were excluded.RESULTS:
During 2012-2013, 72â 677 adult trauma patients admitted to hospitals in England and Wales were identified. 397 patients had an indication(s) and no contraindications for REBOA with evidence of haemorrhagic shock 69% men, median age 43â years and median Injury Severity Score 32. Overall mortality was 32%. Major trauma centres (MTCs) received the highest concentration of potential REBOA patients, and would be anticipated to receive a patient in whom REBOA may be utilised every 95â days, increasing to every 46â days in the 10 MTCs with the highest attendance of this injury type.CONCLUSIONS:
This TARN database analysis has identified a small group of severely injured, resource intensive patients with a highly lethal injury that is theoretically amenable to REBOA. The highest density of these patients is seen at MTCs, and as such a planned evaluation of REBOA should be further considered in these hospitals.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Aorta
/
Ressuscitação
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Choque Hemorrágico
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Traumatismo Múltiplo
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Oclusão com Balão
/
Procedimentos Endovasculares
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Aged
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Aged80
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Female
/
Humans
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Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Emerg Med J
Assunto da revista:
MEDICINA DE EMERGENCIA
Ano de publicação:
2015
Tipo de documento:
Article
País de afiliação:
Estados Unidos