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Research article
Byungchul Yu
Gachon University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-2444-2343
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: The trauma center and multidisciplinary management protocols have been proved to improve the outcomes of severely injured patients. Hemorrhage from pelvic injury is associated with high mortality and is a common cause of preventable trauma death. This study aims to evaluate the effects of the establishment of a trauma center and management protocols on the outcomes of hemodynamically unstable patients with pelvic fractures.
Methods: Hemodynamically unstable patients with pelvic fractures were reviewed retrospectively over a 10-year period. They were grouped into periods 1 and 2, which were defined as before and after the establishment of a trauma center and protocols, respectively. Basic characteristics and outcomes were compared between periods.
Results: This study enrolled a total of 106 patients. Basic and physiological characteristics were not significantly different in both periods. Pre-peritoneal packing (PPP) and resuscitative endovascular balloon occlusion of aorta (REBOA) were only performed in period 2 (PPP, N = 27; REBOA, N = 10). In period 2, the time from emergency room arrival to hemostatic intervention was significantly shorter (269 ± 132.4 min. vs. 147.2 ± 95.5 min., p < 0.0001), and mortality due to acute hemorrhage was significantly decreased (33.3% vs. 8.6%, p = 0.018). The multivariate logistic regression analysis identified age, ISS, and period 1 as independent risk factors for mortality.
Conclusion: The establishment of a trauma center and multidisciplinary management protocols, such as PPP and REBOA, improved the outcomes of hemodynamically unstable patients with pelvic fractures.
Keywords
Pelvic, Trauma, Trauma center, Pre-peritoneal pelvic packing, REBOA
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This is a preprint. It has not completed peer review.
Research article
Byungchul Yu
Gachon University
Corresponding Author
ORCiD: https://orcid.org/0000-0002-2444-2343
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 06 Jan, 2021
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Surgery
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: The trauma center and multidisciplinary management protocols have been proved to improve the outcomes of severely injured patients. Hemorrhage from pelvic injury is associated with high mortality and is a common cause of preventable trauma death. This study aims to evaluate the effects of the establishment of a trauma center and management protocols on the outcomes of hemodynamically unstable patients with pelvic fractures.
Methods: Hemodynamically unstable patients with pelvic fractures were reviewed retrospectively over a 10-year period. They were grouped into periods 1 and 2, which were defined as before and after the establishment of a trauma center and protocols, respectively. Basic characteristics and outcomes were compared between periods.
Results: This study enrolled a total of 106 patients. Basic and physiological characteristics were not significantly different in both periods. Pre-peritoneal packing (PPP) and resuscitative endovascular balloon occlusion of aorta (REBOA) were only performed in period 2 (PPP, N = 27; REBOA, N = 10). In period 2, the time from emergency room arrival to hemostatic intervention was significantly shorter (269 ± 132.4 min. vs. 147.2 ± 95.5 min., p < 0.0001), and mortality due to acute hemorrhage was significantly decreased (33.3% vs. 8.6%, p = 0.018). The multivariate logistic regression analysis identified age, ISS, and period 1 as independent risk factors for mortality.
Conclusion: The establishment of a trauma center and multidisciplinary management protocols, such as PPP and REBOA, improved the outcomes of hemodynamically unstable patients with pelvic fractures.
Figure 1
Figure 2
Figure 3
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