ArticleJournal of trauma and injury2025
Venous phase extravasation on computed tomography is a red flag sign in critical/severe pelvic injuries.
Article in Journal of trauma and injury, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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5 authors.
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Abstract
purposeManaging hemodynamically unstable patients with pelvic fractures is highly challenging, particularly when vascular injuries are present, as these can significantly worsen prognosis. This study evaluated outcomes in patients with pelvic trauma and vascular injuries prior to the introduction of preperitoneal pelvic packing.
methodsWe retrospectively reviewed the medical records of 195 patients with pelvic injuries who presented to the emergency room of our hospital between May 2003 and August 2013.
resultsAmong the 195 patients, 34 had vascular injuries and 161 had nonvascular injuries. The vascular injury group had significantly higher transfusion rates (82.4% vs. 11.8%, P<0.001) and required a greater mean number of packed red blood cell units than the nonvascular group (5.2±5.5 vs. 0.4±1.4, P<0.001). Subgroup analysis within the vascular injury cohort revealed significant differences between patients with venous phase extravasation (n=5) and those with isolated arterial phase extravasation (n=29) in median packed red blood cell units transfused (12.5 units vs. 3 units; P=0.014), cardiac arrest rate (80.0% vs. 10.3%, P=0.003), and mortality rate (60.0% vs. 10.3%, P=0.029). Notably, patients with isolated venous extravasation showed a significantly higher mortality rate compared to those with isolated arterial extravasation (100% vs. 10.3%, P=0.004).
conclusionsVenous phase extravasation was associated with higher transfusion requirements, cardiac arrest incidence, and mortality compared to arterial extravasation.
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