Contemporary Utilization and Outcomes of Resuscitative Endovascular Balloon Occlusion of the Aorta for Traumatic Noncompressible Torso Hemorrhage in Korea: A Retrospective Multi-Center Study

Abstract

Purpose: This study aimed to evaluate the utilization and outcomes of resuscitative endovascular balloonocclusion of the aorta (REBOA) in managing noncompressible torso hemorrhage (NCTH) among traumapatients in Korea. The evolution of REBOA and its impact on patient survival was investigated as well aspredictors of mortality. Methods: This retrospective study included 234 post-REBOA patients from 5 leading regional traumacenters across Korea between 2016 and 2021. Primary outcomes were in-hospital mortality, andsecondary outcomes were various clinical parameters regarding REBOA, overall treatment flow, andcomplications. For comparative analyses, patients were dichotomized into in-hospital non-survivors orsurvivors. Then, generalized additive and linear regression models were used to evaluate the trend of in-hospital mortality. Results: The overall in-hospital mortality was 65.4%. The survivors had a higher proportion ofresponders following REBOA (87.7% vs 62.7%, p < 0.001). Key variables influencing outcomes includedtotal occlusion time, red blood cell transfusion volume within the first 24 hours, revised trauma score,and systolic blood pressure gap. These factors significantly correlated with mortality rates in multivariatelogistic regression. Conclusion: Over 6 years, survival rates for NCTH patients undergoing REBOA in Korea have shownimprovement. Despite diverse REBOA protocols across institutions, the results underscore the need forcontinued research, standardized practices, and national quality control measures to further optimizepatient outcome and establish more effective treatment protocols for NCTH.