Evidence map›Paper›PMID 40196096›Full record

ArticleCureus2025

A Comparative Analysis of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA), Resuscitative Thoracotomy, and Nonprocedural Care for the Management of Life-Threatening Traumatic Torso Hemorrhage.

Samantha Spence, Jennifer Fox, Thomas P Hoag, Madison Yeager, Claire Schroll, Thomas Koch, William Rudder, Matthew Whalen, Dana Alshekhlee, Blake Miyamoto and 4 more

Abstract read
In one paragraph

Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Samantha SpenceDepartment of Trauma Surgery, Saint Louis University School of Medicine, St. Louis, USA.
Jennifer FoxDepartment of Trauma Surgery, Saint Louis University School of Medicine, St. Louis, USA.
Thomas P HoagDepartment of Trauma Surgery, Saint Louis University School of Medicine, St. Louis, USA.
Madison YeagerDepartment of Trauma Surgery, Saint Louis University School of Medicine, St. Louis, USA.
Claire SchrollDepartment of Trauma Surgery, Saint Louis University School of Medicine, St. Louis, USA.
Thomas KochDepartment of Trauma Surgery, Saint Louis University School of Medicine, St. Louis, USA.
William RudderDepartment of Trauma Surgery, Saint Louis University School of Medicine, St. Louis, USA.
Matthew WhalenDepartment of Trauma Surgery, Saint Louis University School of Medicine, St. Louis, USA.
Dana AlshekhleeDepartment of Trauma Surgery, Saint Louis University School of Medicine, St. Louis, USA.
Blake MiyamotoDepartment of Trauma Surgery, Saint Louis University School of Medicine, St. Louis, USA.
Diana FanDepartment of Trauma Surgery, Saint Louis University School of Medicine, St. Louis, USA.
Christopher SandovalDepartment of Surgery/Emergency Medicine, Sisters of St. Mary (SSM) Health Saint Louis University Hospital, St. Louis, USA.
Raymond I OkekeDepartment of General Surgery, Sisters of St. Mary (SSM) Health Saint Louis University Hospital, St. Louis, USA.
John CulhaneDepartment of Trauma Surgery, Sisters of St. Mary (SSM) Health Saint Louis University Hospital, St. Louis, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThis study aimed to compare the mortality of resuscitative endovascular balloon occlusion of the aorta (REBOA) with emergency department thoracotomy (EDT) and nonprocedural resuscitation (NPR) in the initial resuscitation of life-threatening acute traumatic hemorrhage.

methodsWe performed a retrospective chart review of all patients who presented at a single urban level I trauma center with noncompressible torso hemorrhage between January 1, 2012, and October 31, 2022. Patients with a life-threatening injury (Abbreviated Injury Scale score >3) involving significant bleeding in the thorax or abdomen were included. Exclusion criteria were life-threatening head injury and mechanism of ground-level fall. Patients were classified according to the primary means of resuscitation: EDT, REBOA, or blood products and fluid (hemostatic resuscitation) without procedural intervention. The primary outcome was in-hospital mortality. Univariate and multivariate analyses were performed. Covariates included patient demographics, mechanism of injury, and injury severity.

resultsTwo hundred sixty-seven cases met the criteria for inclusion. Initial resuscitation was EDT for 71 patients, REBOA for 17, and hemostatic resuscitation only for 179. Mortality rates for EDT compared to REBOA were 64 (90.1%) vs. 10 (58.8%) (p = 0.0051). The adjusted odds ratio (OR) was 0.09 (p = 0.009). The mortality rate for hemostatic resuscitation alone was 41 (22.9%) (p < 0.001) with an OR of 0.02 compared with those who received either EDT or REBOA. This finding remained significant when REBOA and conservative management were compared directly, excluding EDT patients (p = 0.0033).

conclusionsMortality associated with EDT is higher than that of REBOA. Mortality for both is higher than nonprocedural hemostatic resuscitation. REBOA is an appropriate salvage maneuver for patients with life-threatening abdominopelvic hemorrhage. However, our results do not support liberalizing its indications to patients responsive to hemostatic resuscitation.

Indexed as

aortic occlusionemergency departmentnoncompressible torso hemorrhagereboaresuscitationthoracotomytrauma

Identifiers

PMID40196096
PMCPMC11973399

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.