The effect of participation of interventional radiology team in a primary trauma survey on patient outcome - 31/03/22
, Toru Hifumi b, Hisashi Yoneyama a, Kazushige Inoue a, Satoshi Seki a, Ippei Jimbo a, Hiroaki Takada a, Koichi Nagasawa a, Saiko Kohara a, Tsuyoshi Hishikawa a, Eiju Hasegawa a, Kohei Morimoto c, Yoshiaki Ichinose c, Fumie Sato c, Nobuaki Kiriu d, Junichi Matsumoto e, Shoji Yokobori f
Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.
Connectez-vous pour en bénéficier!
Highlights |
• | Participation of interventional radiologists in primary trauma surveys shortens time to hemostasis. Consequently, patients with hemodynamically unstable trauma survive better. |
• | Patients with hemodynamically unstable trauma have a survival rate 24.6% greater than the predictive survival rate via participation of interventional radiologists. |
• | Median intervention initiation and procedure times in patients with hemodynamically unstable trauma are 54 and 48 min, respectively and shorter than those with hemodynamically stable trauma. |
Abstract |
Purpose |
The purpose of this study was to examine the survival benefits of a workflow in which an interventional radiology (IR) team participates in a primary trauma survey on patients with hemodynamically unstable trauma.
Materials and methods |
A retrospective observational study was conducted between 2012 and 2019 at a single institution. Patients who underwent an IR procedure as the initial hemostasis were assigned to the hemodynamically stable group (HSG) or hemodynamically unstable group (HUG). The primary and secondary outcomes were survival at hospital discharge compared with the probability of survival (Ps) and the time course.
Results |
A total of 160 patients (100 men, 60 women; median age, 57.5 years [interquartile range (IQR): 31.5–72 years]) with an injury severity score of 24 (IQR: 13.75–34) were included. A total of 125 patients were included in the HSG group and 35 patients in the HUG group. The observational survival rate was significantly greater than the Ps rate by 4.9% (95% confidence interval [CI]: 1.6–8.4%; P = 0.005) in HSG and by 24.6% in HUG (95% CI: 16.9–32.3%; P < 0.001). The observational survival rate was significantly greater than Ps in HUG than in HSG (P < 0.001). The median time to initiate IR procedures and the median procedure time in HUG were 54 min [IQR: 45–66 min] and 48 min [IQR: 30–85 min], respectively; both were significantly shorter than those in the HSG.
Conclusion |
A trauma workflow utilizing an IR team in a primary survey is associated with improved survival of patients with hemodynamically unstable trauma when compared with Ps with a shorter time course.
Le texte complet de cet article est disponible en PDF.Keywords : Injury severity score, Survival benefit, Radiology interventional, Transcatheter arterial embolization, Switch to surgery, Trauma workflow
Plan
Vol 103 - N° 4
P. 209-215 - avril 2022 Retour au numéro
Article précédent
- Early results of a French care-related adverse events database in radiology
- Jean-Paul Beregi, Olivier Seror, Jean-Jacques Wenger, Thomas Caramella, Claire Boutet, Jean-Nicolas Dacher
- Prediction of clinical response to corticosteroid or platelet-rich plasma injection in plantar fasciitis with MRI: A prospective, randomized, double-blinded study
- Arnaud Breton, Christophe Leplat, Marie-Christine Picot, Safa Aouinti, Patrice Taourel, Isabelle Laffont, Marc Julia, Catherine Cyteval
Bienvenue sur EM-consulte, la référence des professionnels de santé.