Immediate Angiography and Decreased In-Hospital Mortality of Adult Trauma Patients: A Nationwide Study

Ryo Yamamoto, Katsuya Maeshima, Tomohiro Funabiki, Brian J. Eastridge, Ramon F. Cestero, Junichi Sasaki

研究成果: ジャーナルへの寄稿学術論文査読

1 被引用数 (Scopus)

抄録

Purpose: This study aimed to elucidate whether immediate angiography within 30 min is associated with lower in-hospital mortality compared with non-immediate angiography. Materials and Methods: We conducted a retrospective cohort study using a nationwide trauma databank (2019–2020). Adult trauma patients who underwent emergency angiography within 12 h after hospital arrival were included. Patients who underwent surgery before angiography were excluded. Immediate angiography was defined as one performed within 30 min after arrival (door-to-angio time ≤ 30 min). In-hospital mortality and non-operative management (NOM) failure were compared between patients with immediate and non-immediate angiography. Inverse probability weighting with propensity scores was conducted to adjust patient demographics, injury mechanism and severity, vital signs on hospital arrival, and resuscitative procedures. A restricted cubic spline curve was drawn to reveal survival benefits by door-to-angio time. Results: Among 1,455 patients eligible for this study, 92 underwent immediate angiography. Angiography ≤ 30 min was associated with decreased in-hospital mortality (5.0% vs 11.1%; adjusted odds ratio [OR], 0.42 [95% CI, 0.31–0.56]; p < 0.001), as well as lower frequency of NOM failure: thoracotomy and laparotomy after angiography (0.8% vs. 1.8%; OR, 0.44 [0.22–0.89] and 2.6% vs. 6.5%; OR, 0.38 [0.26–0.56], respectively). The spline curve showed a linear association between increasing mortality and prolonged door-to-angio time in the initial 100 min after arrival. Conclusion: In trauma patients, immediate angiography ≤ 30 min was associated with lower in-hospital mortality and fewer NOM failures. Level of Evidence: Level 3b, non randomized controlled cohort/follow up study. Graphical Abstract: (Figure presented.).

本文言語英語
ページ(範囲)472-480
ページ数9
ジャーナルCardioVascular and Interventional Radiology
47
4
DOI
出版ステータス出版済み - 04-2024

All Science Journal Classification (ASJC) codes

  • 放射線学、核医学およびイメージング
  • 循環器および心血管医学

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