Observational studyScandinavian journal of trauma, resuscitation and emergency medicine2013
Comparison between laparotomy first versus angiographic embolization first in patients with pelvic fracture and hemoperitoneum: a nationwide observational study from the Japan Trauma Data Bank.
Observational study in Scandinavian journal of trauma, resuscitation and emergency medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Definition of hemodynamic stability in blunt trauma patients: a systematic review and assessment amongst Dutch trauma team members.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2017Pooled it
- Declining mortality after open pelvis fracture in North America.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Impact of Pelvic Fracture on Patients with Blunt Bowel Mesenteric Injury: Is Immediate Laparotomy Warranted?Life (Basel, Switzerland) · 2023Article
- A clinical prediction model for non-operative management failure in patients with high-grade blunt splenic injury.Heliyon · 2023Article
- Transarterial embolisation is associated with improved survival in patients with pelvic fracture: propensity score matching analyses.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2021Article
- Management of Pelvic Ring Injury Patients With Hemodynamic Instability.Frontiers in surgery · 2020Review
- Trans-arterial embolisation (TAE) in haemorrhagic pelvic injury: review of management and mid-term outcome of a major trauma centre.CVIR endovascular · 2018Review
- Effect of angioembolisation versus surgical packing on mortality in traumatic pelvic haemorrhage: A systematic review and meta-analysis.World journal of emergency medicine · 2018Review
- Article
- Temporal intrailiac balloon occlusion for the treatment of intractable pelvic fracture hemorrhage.Acute medicine & surgery · 2016Article
- Mortality in trauma patients with active arterial bleeding managed by embolization or surgical packing: An observational cohort study of 66 patients.Journal of emergencies, trauma, and shockArticle
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA common dilemma in the management of pelvic fractures is recognizing the presence of associated abdominal injury. The purpose of this study was to determine the association between initial therapeutic intervention (laparotomy or transcatheter arterial embolization (TAE)) and mortality.
methodsThis was a cohort study using the Japan Trauma Data Bank between 2004 and 2010, including blunt trauma patients with pelvic fractures and positive Focused Assessment with Sonography in Trauma (FAST) results. Eligible patients were restricted to those who underwent laparotomy or TAE/angiography as the initial therapeutic intervention. Crude and adjusted odds ratio (AOR) for in-hospital mortality were compared between the laparotomy first and TAE first groups (reference group). Multiple logistic regression analysis and propensity score adjusted analysis were used to adjust for clinically relevant confounders, including the severity of injury.
resultsOf the 317 participants, 123 patients underwent laparotomy first and 194 patients underwent TAE first. The two groups were similar in terms of age, although the laparotomy first group had higher mean Injury Severity Scores (ISS) and higher mean scores based on the abdominal Abbreviated Injury Scale (AIS), as well as lower mean pelvic AIS and systolic blood pressure (SBP). Half of the patients who were hypotensive (SBP < 90 mmHg) on arrival underwent TAE first. The laparotomy first group had a significantly higher crude in-hospital mortality (41% vs. 27%; P < 0.01). After adjusting for confounders, the choice of initial therapeutic intervention did not affect the in-hospital mortality (AOR, 1.20; 95% Confidence Interval (CI), 0.61-2.39). Even in the limited subgroup of hypotensive patients (SBP 66-89 mmHg and SBP < 65 mmHg subgroup), the effect was similar (AOR, 1.50; 95% CI, 0.56-4.05 and AOR, 1.05; 95% CI, 0.44-3.03).
conclusionsIn Japan, laparotomy and TAE are equally chosen as the initial therapeutic intervention regardless of hemodynamic status. No significant difference was seen between the laparotomy first and TAE first groups regarding in-hospital mortality.
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