OBJECTIVE: The objective of our study was to evaluate the long-term trends in the use of angiography and embolization for abdominopelvic injuries. MATERIALS AND METHODS: Utilization rates for pelvic and abdominal angiography, arterial embolization, and CT were analyzed for trauma patients with pelvic fractures and liver and kidney injuries admitted to a level 1 trauma center from 1996 to 2010. Multivariable linear regression was used to evaluate trends in the use of angioembolization. RESULTS: A total of 9145 patients were admitted for abdominopelvic injuries during the study period. Pelvic angiography decreased annually by 5.0% (95% CI, -6.4% to -3.7%) from 1996 to 2002 and by 1.8% (-2.4% to -1.2%) from 2003 to 2010. Embolization rates for these patients varied from 49% in 1997 to 100% in 2010. Utilization of pelvic CT on the day of admission increased significantly during this period. Abdominal angiography for liver and kidney injuries decreased annually by 3.3% (95% CI, -4.8% to -1.8%) and 2.0% (-4.3% to 0.3%) between 1996 and 2002 and by 0.8% (95% CI, -1.4% to -0.1%) and 0.9% (-2.0% to 0.1%) from 2003 to 2010, respectively. Embolization rates ranged from 25% in 1999 to 100% in 2010 for liver injuries and from 0% in 1997 to 80% in 2002 for kidney injuries. Abdominal CT for liver and kidney injuries on the day of admission also increased. CONCLUSION: A significant decrease in angiography use for trauma patients with pelvic fractures, liver injuries, and kidney injuries from 1996 to 2010 and a trend toward increasing embolization rates among patients who underwent angiography were found. These findings reflect a declining role of angiography for diagnostic purposes and emphasize the importance of angiography as a means to embolization for management.
OBJECTIVE: The objective of our study was to evaluate the long-term trends in the use of angiography and embolization for abdominopelvic injuries. MATERIALS AND METHODS: Utilization rates for pelvic and abdominal angiography, arterial embolization, and CT were analyzed for traumapatients with pelvic fractures and liver and kidney injuries admitted to a level 1 trauma center from 1996 to 2010. Multivariable linear regression was used to evaluate trends in the use of angioembolization. RESULTS: A total of 9145 patients were admitted for abdominopelvic injuries during the study period. Pelvic angiography decreased annually by 5.0% (95% CI, -6.4% to -3.7%) from 1996 to 2002 and by 1.8% (-2.4% to -1.2%) from 2003 to 2010. Embolization rates for these patients varied from 49% in 1997 to 100% in 2010. Utilization of pelvic CT on the day of admission increased significantly during this period. Abdominal angiography for liver and kidney injuries decreased annually by 3.3% (95% CI, -4.8% to -1.8%) and 2.0% (-4.3% to 0.3%) between 1996 and 2002 and by 0.8% (95% CI, -1.4% to -0.1%) and 0.9% (-2.0% to 0.1%) from 2003 to 2010, respectively. Embolization rates ranged from 25% in 1999 to 100% in 2010 for liver injuries and from 0% in 1997 to 80% in 2002 for kidney injuries. Abdominal CT for liver and kidney injuries on the day of admission also increased. CONCLUSION: A significant decrease in angiography use for traumapatients with pelvic fractures, liver injuries, and kidney injuries from 1996 to 2010 and a trend toward increasing embolization rates among patients who underwent angiography were found. These findings reflect a declining role of angiography for diagnostic purposes and emphasize the importance of angiography as a means to embolization for management.
Authors: Daniel C Cullinane; Henry J Schiller; Martin D Zielinski; Jaroslaw W Bilaniuk; Bryan R Collier; John Como; Michelle Holevar; Enrique A Sabater; S Andrew Sems; W Matthew Vassy; Julie L Wynne Journal: J Trauma Date: 2011-12
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Authors: Federico Coccolini; Raul Coimbra; Carlos Ordonez; Yoram Kluger; Felipe Vega; Ernest E Moore; Walt Biffl; Andrew Peitzman; Tal Horer; Fikri M Abu-Zidan; Massimo Sartelli; Gustavo P Fraga; Enrico Cicuttin; Luca Ansaloni; Michael W Parra; Mauricio Millán; Nicola DeAngelis; Kenji Inaba; George Velmahos; Ron Maier; Vladimir Khokha; Boris Sakakushev; Goran Augustin; Salomone di Saverio; Emanuil Pikoulis; Mircea Chirica; Viktor Reva; Ari Leppaniemi; Vassil Manchev; Massimo Chiarugi; Dimitrios Damaskos; Dieter Weber; Neil Parry; Zaza Demetrashvili; Ian Civil; Lena Napolitano; Davide Corbella; Fausto Catena Journal: World J Emerg Surg Date: 2020-03-30 Impact factor: 5.469