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Research article
Transcatheter arterial embolization is efficient and safe for paediatric blunt torso trauma: a case-control study
Chiaki Toida
Yokohama City University Graduate School of Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0003-4551-4841
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Emergency Medicine.
Background: It remains unclear whether transcatheter arterial embolization (TAE) is as safe and effective for paediatric patients with blunt torso trauma as it is for adults in Japan, owing to few trauma cases and sporadic case reports. The study aimed to compare the efficacy and safety of TAE in paediatric patients (age ≤ 15 years) with blunt torso trauma to those of TAE in adult patients.
Methods: This was a single-centre, retrospective chart review study that included blunt torso trauma patients who underwent TAE in the trauma centre from 2012 to 2017. The comparative study was carried out between a “paediatric patient group” and an “adult patient group”.The outcome measures for TAE were the success of haemorrhage control and complications and standardised mortality ratio (SMR).
Results: A total of 504 patients with blunt torso trauma were transported to the trauma centre. Among them, 23% (N=114) of patients with blunt torso trauma underwent TAE, including 15 paediatric and 99 adult patients. There was no significant difference between the use of TAE in paediatric and adult patients with blunt torso trauma (29% vs. 22%, P=.221). The median age was 11 (IQR 7–14) years for paediatric patients. The predicted mortality (PMR) rate and SMR for paediatric patients were lower than that for adult patients (18.3% vs. 25.9%, P =.026, and 0.37 vs. 0.54). The rate of effective haemorrhage control without repeated TAE or additional surgical intervention was 93% in paediatric patients, which was similar to that in adult patients (88%). There were no complications in the paediatric patients at our centre. There were no significant differences in the proportion of paediatric patients that underwent surgery before TAE or urgent blood transfusion (33% vs. 26%, P =.566, or 67% vs. 85%, P =.084).
Conclusions: It is possible to provide an equal level of care related to TAE for both paediatric and adult patients as it relates to TAE for blunt torso trauma with haemorrhage in the trauma centre. We should prepare alternative haemorrhage control procedures as soon as possible whenever the patients reach a hemodynamic unstable state.
Keywords
Paediatric patients, trauma care, nonsurgical intervention, intervention radiology, transcatheter arterial embolization, complication, in-hospital mortality, standardized mortality ratio
Figure 1
This is a list of supplementary files associated with this preprint. Click to download.
- Table15.pdf
Table 1. Characteristics and outcome compared between paediatric and adult trauma patients with transcatheter arterial embolization. Table 2. Vital sign and blood examination at arrival to the hospital compared between paediatric and adult trauma patients with transcatheter arterial embolization. Table 3. Blood transfusion during primary trauma care compared between paediatric and adult trauma patients with transcatheter arterial embolization. Table 4. Summary of intervention radiology compared between paediatric and adult trauma patients with transcatheter arterial embolization. Table 5. Detailed summary of paediatric patients with transcatheter arterial embolization.
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Peer Review Timeline
CURRENT STATUS: Published
Version 2
Posted 14 Sep, 2020
No comments provided
Editorial decision: Minor revision
On 12 Oct, 2020
Review #1 received
Received 10 Oct, 2020
Reviewer #1 agreed
On 11 Sep, 2020
Reviewers invited
Invitations sent on 10 Sep, 2020
Editor assigned
On 08 Sep, 2020
Submission checks complete
On 07 Sep, 2020
Editor invited
On 07 Sep, 2020
No comments provided
Editorial decision: Minor revision
On 28 Aug, 2020
Review #2 received
Received 27 Aug, 2020
Review #1 received
Received 27 Aug, 2020
Reviewer #3 agreed
On 09 Aug, 2020
Reviewer #2 agreed
On 06 Aug, 2020
Editor assigned
On 05 Aug, 2020
Reviewers invited
Invitations sent on 05 Aug, 2020
Reviewer #1 agreed
On 05 Aug, 2020
Submission checks complete
On 05 Aug, 2020
Editor invited
On 05 Aug, 2020
First submitted
On 30 Jul, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Critical Care & Emergency Medicine
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This preprint is under consideration at BMC Emergency Medicine. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Transcatheter arterial embolization is efficient and safe for paediatric blunt torso trauma: a case-control study
Chiaki Toida
Yokohama City University Graduate School of Medicine
Corresponding Author
ORCiD: https://orcid.org/0000-0003-4551-4841
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 2
Posted 14 Sep, 2020
No comments provided
Editorial decision: Minor revision
On 12 Oct, 2020
Review #1 received
Received 10 Oct, 2020
Reviewer #1 agreed
On 11 Sep, 2020
Reviewers invited
Invitations sent on 10 Sep, 2020
Editor assigned
On 08 Sep, 2020
Submission checks complete
On 07 Sep, 2020
Editor invited
On 07 Sep, 2020
No comments provided
Editorial decision: Minor revision
On 28 Aug, 2020
Review #2 received
Received 27 Aug, 2020
Review #1 received
Received 27 Aug, 2020
Reviewer #3 agreed
On 09 Aug, 2020
Reviewer #2 agreed
On 06 Aug, 2020
Editor assigned
On 05 Aug, 2020
Reviewers invited
Invitations sent on 05 Aug, 2020
Reviewer #1 agreed
On 05 Aug, 2020
Submission checks complete
On 05 Aug, 2020
Editor invited
On 05 Aug, 2020
First submitted
On 30 Jul, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Critical Care & Emergency Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at BMC Emergency Medicine.
Background: It remains unclear whether transcatheter arterial embolization (TAE) is as safe and effective for paediatric patients with blunt torso trauma as it is for adults in Japan, owing to few trauma cases and sporadic case reports. The study aimed to compare the efficacy and safety of TAE in paediatric patients (age ≤ 15 years) with blunt torso trauma to those of TAE in adult patients.
Methods: This was a single-centre, retrospective chart review study that included blunt torso trauma patients who underwent TAE in the trauma centre from 2012 to 2017. The comparative study was carried out between a “paediatric patient group” and an “adult patient group”.The outcome measures for TAE were the success of haemorrhage control and complications and standardised mortality ratio (SMR).
Results: A total of 504 patients with blunt torso trauma were transported to the trauma centre. Among them, 23% (N=114) of patients with blunt torso trauma underwent TAE, including 15 paediatric and 99 adult patients. There was no significant difference between the use of TAE in paediatric and adult patients with blunt torso trauma (29% vs. 22%, P=.221). The median age was 11 (IQR 7–14) years for paediatric patients. The predicted mortality (PMR) rate and SMR for paediatric patients were lower than that for adult patients (18.3% vs. 25.9%, P =.026, and 0.37 vs. 0.54). The rate of effective haemorrhage control without repeated TAE or additional surgical intervention was 93% in paediatric patients, which was similar to that in adult patients (88%). There were no complications in the paediatric patients at our centre. There were no significant differences in the proportion of paediatric patients that underwent surgery before TAE or urgent blood transfusion (33% vs. 26%, P =.566, or 67% vs. 85%, P =.084).
Conclusions: It is possible to provide an equal level of care related to TAE for both paediatric and adult patients as it relates to TAE for blunt torso trauma with haemorrhage in the trauma centre. We should prepare alternative haemorrhage control procedures as soon as possible whenever the patients reach a hemodynamic unstable state.
Figure 1