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Research article
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
Background: It remains unclear whether transcatheter arterial embolisation (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 performed in paediatric (age ≤ 15 years) and adult patients with blunt torso trauma.
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, out of which 23% (N=114) 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 paediatric patients’ median age was 11 years (IQR 7–14). The predicted mortality rate (PMR) and SMR for paediatric patients were lower than those 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 paediatric patients at our centre. There were no significant differences in the proportion of paediatric patients who 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 paediatric and adult patients as it relates to TAE for blunt torso trauma with haemorrhage in the trauma centre. Alternative haemorrhage control procedures should be established as soon as possible whenever the patients reach a haemodynamically unstable state.
Keywords
Paediatric patients, trauma care, nonsurgical intervention, intervention radiology, transcatheter arterial embolisation, complication, in-hospital mortality, standardised mortality ratio
Figure 1
This is a list of supplementary files associated with this preprint. Click to download.
- Table15rev4.xlsx
Table 1. Characteristics and outcome compared between paediatric and adult trauma patients with transcatheter arterial embolisation. Table 2. Vital sign/blood examination between paediatric and adult trauma patients with transcatheter arterial embolisation. Table 3. Blood transfusion during primary trauma care compared between paediatric and adult trauma patients with transcatheter arterial embolisation. Table 4. Summary of intervention radiology compared between paediatric and adult trauma patients with transcatheter arterial embolisation. Table 5. Detailed summary of paediatric patients with transcatheter arterial embolisation.
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CURRENT STATUS: Published
View the published article at BMC Emergency Medicine.
Version 3
Posted 27 Oct, 2020
No community comments so far
Editorial decision: Accept
On 21 Oct, 2020
Editor assigned
On 21 Oct, 2020
Submission checks complete
On 20 Oct, 2020
Editor invited
On 20 Oct, 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
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PDF Downloads: ...
HTML Views: ...
Subject Areas
Critical Care & Emergency Medicine
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A new preprint design is coming!
We have improved readability, clarity, accessibility, and opportunities for engagement.
See the published version of this preprint at BMC Emergency Medicine.
This is a preprint, 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
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
View the published article at BMC Emergency Medicine.
Version 3
Posted 27 Oct, 2020
No community comments so far
Editorial decision: Accept
On 21 Oct, 2020
Editor assigned
On 21 Oct, 2020
Submission checks complete
On 20 Oct, 2020
Editor invited
On 20 Oct, 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 article at BMC Emergency Medicine.
Background: It remains unclear whether transcatheter arterial embolisation (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 performed in paediatric (age ≤ 15 years) and adult patients with blunt torso trauma.
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, out of which 23% (N=114) 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 paediatric patients’ median age was 11 years (IQR 7–14). The predicted mortality rate (PMR) and SMR for paediatric patients were lower than those 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 paediatric patients at our centre. There were no significant differences in the proportion of paediatric patients who 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 paediatric and adult patients as it relates to TAE for blunt torso trauma with haemorrhage in the trauma centre. Alternative haemorrhage control procedures should be established as soon as possible whenever the patients reach a haemodynamically unstable state.
Figure 1
This is a list of supplementary files associated with this preprint. Click to download.
- Table15rev4.xlsx
Table 1. Characteristics and outcome compared between paediatric and adult trauma patients with transcatheter arterial embolisation. Table 2. Vital sign/blood examination between paediatric and adult trauma patients with transcatheter arterial embolisation. Table 3. Blood transfusion during primary trauma care compared between paediatric and adult trauma patients with transcatheter arterial embolisation. Table 4. Summary of intervention radiology compared between paediatric and adult trauma patients with transcatheter arterial embolisation. Table 5. Detailed summary of paediatric patients with transcatheter arterial embolisation.
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