Positive impact of trauma center to exsanguinating pelvic bone fracture patient survival: A Korean trauma center study
- Authors
- Lee, Mina; Yu, Byungchul; Lee, Giljae; Lee, Jungnam; Choi, Kangkook; Park, Youngeun; Gwak, Jihun; Jang, Myung Jin
- Issue Date
- Jul-2023
- Publisher
- SAGE PUBLICATIONS LTD
- Keywords
- Pelvic bone fracture; pelvic binder; REBOA; EPF; PPP; AE; trauma; trauma center
- Citation
- HONG KONG JOURNAL OF EMERGENCY MEDICINE, v.30, no.4, pp.225 - 235
- Journal Title
- HONG KONG JOURNAL OF EMERGENCY MEDICINE
- Volume
- 30
- Number
- 4
- Start Page
- 225
- End Page
- 235
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/88366
- DOI
- 10.1177/10249079221087799
- ISSN
- 1024-9079
- Abstract
- Background: Trauma center and multidisciplinary management protocols have been proven 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 aimed 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 the pre-phase and post-phase, 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 phases. Pre-peritoneal packing and resuscitative endovascular balloon occlusion of aorta were only performed in the post-phase (pre-peritoneal packing, N= 27; resuscitative endovascular balloon occlusion of aorta, N =10). In the post-phase, the time from emergency department 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 lower (p= 0.003; absolute risk reduction: 0.22; relative risk reduction: 0.72). Multivariate logistic regression analysis identified age, injury severity score, and the pre-phase as independent risk factors for mortality. Conclusion: The establishment of a trauma center and multidisciplinary management protocols, such as pre-peritoneal packing and resuscitative endovascular balloon occlusion of aorta, improved the outcomes of hemodynamically unstable patients with pelvic fractures.
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Collections - 의과대학 > 의학과 > 1. Journal Articles
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