Transcatheter arterial embolization is efficient and safe for paediatric blunt torso trauma: a case-control study
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
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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.
Posted 14 Sep, 2020
On 12 Oct, 2020
Received 10 Oct, 2020
On 11 Sep, 2020
Invitations sent on 10 Sep, 2020
On 08 Sep, 2020
On 07 Sep, 2020
On 07 Sep, 2020
On 28 Aug, 2020
Received 27 Aug, 2020
Received 27 Aug, 2020
On 09 Aug, 2020
On 06 Aug, 2020
On 05 Aug, 2020
Invitations sent on 05 Aug, 2020
On 05 Aug, 2020
On 05 Aug, 2020
On 05 Aug, 2020
On 30 Jul, 2020
Transcatheter arterial embolization is efficient and safe for paediatric blunt torso trauma: a case-control study
Posted 14 Sep, 2020
On 12 Oct, 2020
Received 10 Oct, 2020
On 11 Sep, 2020
Invitations sent on 10 Sep, 2020
On 08 Sep, 2020
On 07 Sep, 2020
On 07 Sep, 2020
On 28 Aug, 2020
Received 27 Aug, 2020
Received 27 Aug, 2020
On 09 Aug, 2020
On 06 Aug, 2020
On 05 Aug, 2020
Invitations sent on 05 Aug, 2020
On 05 Aug, 2020
On 05 Aug, 2020
On 05 Aug, 2020
On 30 Jul, 2020
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