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. 2022 Mar 24;17(3):e0265778.
doi: 10.1371/journal.pone.0265778. eCollection 2022.

Resuscitative endovascular balloon occlusion of the aorta associated with improved survival in hemorrhagic shock

Melike N Harfouche  1 , Marta J Madurska  2 , Noha Elansary  1 , Hossam Abdou  1 , Eric Lang  1 , Joseph J DuBose  3 , Rishi Kundi  1 , David V Feliciano  1 , Thomas M Scalea  1 , Jonathan J Morrison  1
Affiliations

Resuscitative endovascular balloon occlusion of the aorta associated with improved survival in hemorrhagic shock

Melike N Harfouche et al. PLoS One. .

Abstract

Background: Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is controversial as a hemorrhage control adjunct due to lack of data with a suitable control group. We aimed to determine outcomes of trauma patients in shock undergoing REBOA versus no-REBOA.

Methods: This single-center, retrospective, matched cohort study analyzed patients ≥16 years in hemorrhagic shock without cardiac arrest (2000-2019). REBOA (R; 2015-2019) patients were propensity matched 2:1 to historic (H; 2000-2012) and contemporary (C; 2013-2019) groups. In-hospital mortality and 30-day survival were analyzed using chi-squared and log rank testing, respectively.

Results: A total of 102,481 patients were included (R = 57, C = 88,545, H = 13,879). Propensity scores were assigned using age, race, mechanism, lowest systolic blood pressure, lowest Glasgow Coma Score (GCS), and body region Abbreviated Injury Scale scores to generate matched groups (R = 57, C = 114, H = 114). In-hospital mortality was significantly lower in the REBOA group (19.3%) compared to the contemporary (35.1%; p = 0.024) and historic (44.7%; p = 0.001) groups. 30-day survival was significantly higher in the REBOA versus no-REBOA groups.

Conclusion: In a high-volume center where its use is part of a coordinated hemorrhage control strategy, REBOA is associated with improved survival in patients with noncompressible torso hemorrhage.

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Conflict of interest statement

I have read the journal’s policy and the authors of this manuscript have the following competing interests: Jonathan J Morrison is on the Medical Advisory Board of Prytime Medical. The remainder of the authors have no conflicts of interest to report.

Figures

Fig 1
Fig 1. Kaplan-Meier estimates of survival over time to 30 days by group (REBOA, contemporary and historic).
See this image and copyright information in PMC

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