OBJECTIVE: To review the success rate of embolization in stopping hemorrhage for unstable patients with severe pelvic fractures, to calculate the time to achieve embolization, and to determine the yield from angiography. DESIGN: Retrospective review of patients admitted to a Level I trauma center with pelvic fractures during a 5-year period. MATERIALS AND METHODS: Charts were reviewed for Injury Severity Score, age, blood pressure, prothrombin time/partial thromboplastin time, pelvic fracture type, mortality, time to reach the angiography suite, time to achieve embolization, and mechanism of injury. MEASUREMENTS AND MAIN RESULTS: Of 806 patients admitted with pelvic fractures, 35 underwent pelvic angiography, and 15 (1.9%) required embolization. Embolization was successful for all patients. No deaths resulted from ongoing hemorrhage. Angiography yield in initially unstable patients was 64%. The mean age and initial hemodynamic instability were significantly greater in nonsurvivors. The time from arrival in the trauma bay to arrival in the angiography suite ranged from 50 to 1,140 minutes, and the time spent in the angiography suite performing embolization ranged from 50 to 140 minutes, with an average time of 90 minutes. Patients who were embolized within 3 hours of arrival had a significantly greater survival rate. CONCLUSION: Only a small percentage of patients with pelvic fractures require embolization, but when it is used, embolization can be 100% effective. Age, time to achieve embolization, and initial hemodynamic instability appear to be important factors in survival.
OBJECTIVE: To review the success rate of embolization in stopping hemorrhage for unstable patients with severe pelvic fractures, to calculate the time to achieve embolization, and to determine the yield from angiography. DESIGN: Retrospective review of patients admitted to a Level I trauma center with pelvic fractures during a 5-year period. MATERIALS AND METHODS: Charts were reviewed for Injury Severity Score, age, blood pressure, prothrombin time/partial thromboplastin time, pelvic fracture type, mortality, time to reach the angiography suite, time to achieve embolization, and mechanism of injury. MEASUREMENTS AND MAIN RESULTS: Of 806 patients admitted with pelvic fractures, 35 underwent pelvic angiography, and 15 (1.9%) required embolization. Embolization was successful for all patients. No deaths resulted from ongoing hemorrhage. Angiography yield in initially unstable patients was 64%. The mean age and initial hemodynamic instability were significantly greater in nonsurvivors. The time from arrival in the trauma bay to arrival in the angiography suite ranged from 50 to 1,140 minutes, and the time spent in the angiography suite performing embolization ranged from 50 to 140 minutes, with an average time of 90 minutes. Patients who were embolized within 3 hours of arrival had a significantly greater survival rate. CONCLUSION: Only a small percentage of patients with pelvic fractures require embolization, but when it is used, embolization can be 100% effective. Age, time to achieve embolization, and initial hemodynamic instability appear to be important factors in survival.
Authors: Ronald Chang; Erin E Fox; Thomas J Greene; Brian J Eastridge; Ramyar Gilani; Kevin K Chung; Stacia M DeSantis; Joseph J DuBose; Jeffrey S Tomasek; Gerald R Fortuna; Valerie G Sams; S Rob Todd; Jeanette M Podbielski; Charles E Wade; John B Holcomb Journal: J Trauma Acute Care Surg Date: 2017-07 Impact factor: 3.313
Authors: Andrew Smith; Jean-Francois Ouellet; Daniel Niven; Andrew W Kirkpatrick; Elijah Dixon; Scott D'Amours; Chad G Ball Journal: Can J Surg Date: 2013-12 Impact factor: 2.089
Authors: Diederik O Verbeek; Diederik Verbeek; Michael Sugrue; Zsolt Balogh; Danny Cass; Ian Civil; Ian Harris; Thomas Kossmann; Steve Leibman; Valerie Malka; Anthony Pohl; Sudhakar Rao; Martin Richardson; Michael Schuetz; Caesar Ursic; Vanessa Wills Journal: World J Surg Date: 2008-08 Impact factor: 3.352
Authors: A Pinto; R Niola; G Tortora; G Ponticiello; G Russo; L Di Nuzzo; N Gagliardi; M Scaglione; S Merola; C Stavolo; F Maglione; L Romano Journal: Radiol Med Date: 2010-01-15 Impact factor: 3.469