TY - JOUR
T1 - Delays in Surgical Intervention and Temporary Hemostasis Using Resuscitative Endovascular Balloon Occlusion of the aorta (REBOA)
T2 - Influence of Time to Operating Room on Mortality
AU - Yamamoto, Ryo
AU - Cestero, Ramon F.
AU - Muir, Mark T.
AU - Jenkins, Donald H.
AU - Eastridge, Brian J.
AU - Funabiki, Tomohiro
AU - Sasaki, Junichi
N1 - Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020/12
Y1 - 2020/12
N2 - Background: The optimal candidates for resuscitative endovascular balloon occlusion of the aorta (REBOA) remain unclear. We hypothesized that patients who experience delays in surgical intervention would benefit from REBOA. Methods: Using the Japan Trauma Databank (2014–2019), patients transferred to the operating room (OR) within 3 h were identified. Patients treated with REBOA were matched with those without REBOA using propensity scores, and further divided based on the transfer time to OR: ≤ 1 h (early), 1–2 h (delayed), and >2 h (significantly-delayed). Survival to discharge was compared. Results: Among 5258 patients, 310 underwent REBOA. In 223 matched pairs, patients treated with REBOA had improved survival (56.5% vs. 31.8%; p < 0.01), although in-hospital mortality was reduced by REBOA only in the delayed and significantly-delayed subgroups (HR = 0.43 [0.28–0.65] and 0.42 [0.25–0.71]). Conclusions: REBOA-treated trauma patients who experience delays in surgical intervention (>1 h) have improved survival.
AB - Background: The optimal candidates for resuscitative endovascular balloon occlusion of the aorta (REBOA) remain unclear. We hypothesized that patients who experience delays in surgical intervention would benefit from REBOA. Methods: Using the Japan Trauma Databank (2014–2019), patients transferred to the operating room (OR) within 3 h were identified. Patients treated with REBOA were matched with those without REBOA using propensity scores, and further divided based on the transfer time to OR: ≤ 1 h (early), 1–2 h (delayed), and >2 h (significantly-delayed). Survival to discharge was compared. Results: Among 5258 patients, 310 underwent REBOA. In 223 matched pairs, patients treated with REBOA had improved survival (56.5% vs. 31.8%; p < 0.01), although in-hospital mortality was reduced by REBOA only in the delayed and significantly-delayed subgroups (HR = 0.43 [0.28–0.65] and 0.42 [0.25–0.71]). Conclusions: REBOA-treated trauma patients who experience delays in surgical intervention (>1 h) have improved survival.
KW - Resuscitation
KW - Resuscitative endovascular balloon occlusion of the aorta
KW - Trauma
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U2 - 10.1016/j.amjsurg.2020.07.017
DO - 10.1016/j.amjsurg.2020.07.017
M3 - Article
C2 - 32739046
AN - SCOPUS:85088954627
SN - 0002-9610
VL - 220
SP - 1485
EP - 1491
JO - American Journal of Surgery
JF - American Journal of Surgery
IS - 6
ER -