Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Observational Study
. 2024 Mar;68(2):185-193.
doi: 10.1111/1754-9485.13623. Epub 2024 Jan 31.

A retrospective observational study assessing mortality after pelvic trauma embolisation

Warren Clements  1   2   3 , Talulla Dunne  1   4 , Steven Clare  1 , Matthew Lukies  1   5 , Mark Fitzgerald  2   3   6 , Joseph Mathew  2   3   6 , Helen Kavnoudias  1   2 , Adil Zia  1 , Ee Jun Ban  3   6 , Annabelle Skelley  1 , Jim Koukounaras  1   2
Affiliations
Observational Study

A retrospective observational study assessing mortality after pelvic trauma embolisation

Warren Clements et al. J Med Imaging Radiat Oncol. 2024 Mar.

Abstract

Introduction: Trauma to the pelvic ring and associated haemorrhage represent a management challenge for the multidisciplinary trauma team. In up to 10% of patients, bleeding can be the result of an arterial injury and mortality is reported as high as 89% in this cohort. We aimed to assess the mortality rate after pelvic trauma embolisation and whether earlier embolisation improved mortality.

Methods: Retrospective study at single tertiary trauma and referral centre, between 1 January 2009 and 30 June 2022. All adult patients who received embolisation following pelvic trauma were included. Patients were excluded if angiography was performed but no embolisation performed.

Results: During the 13.5-year time period, 175 patients underwent angiography and 28 were excluded, leaving 147 patients in the study. The all-cause mortality rate at 30-days was 11.6% (17 patients). The median time from injury to embolisation was 6.3 h (range 2.8-418.4). On regression analysis, time from injury to embolisation was not associated with mortality (OR 1.01, 95% CI 0.952-1.061). Increasing age (OR 1.20, 95% CI 1.084-1.333) and increasing injury severity score (OR 1.14, 95% CI 1.049-1.247) were positively associated with all-cause 30-day mortality, while non-selective embolisation (OR 0.11, 95% CI 0.013-0.893) was negatively associated.

Conclusion: The all-cause mortality rate at 30-days in or cohort was very low. In addition, earlier time from injury to embolisation was not positively associated with all-cause 30-day mortality. Nevertheless, minimising this remains a fundamental principle of the management of bleeding in pelvic trauma.

Keywords: embolisation; fracture; pelvic; trauma.

PubMed Disclaimer

References

    1. Rommens PM, Hofmann A, Hessmann MH. Management of acute hemorrhage in pelvic trauma: an overview. Eur J Trauma Emerg Surg 2010; 36: 91–99.
    1. Verbeek D, Sugrue M, Balogh Z et al. Acute management of hemodynamically unstable pelvic trauma patients: time for a change? Multicenter review of recent practice. World J Surg 2008; 32: 1874–1882.
    1. Vaidya R, Waldron J, Scott A, Nasr K. Angiography and embolization in the management of bleeding pelvic fractures. J Am Acad Orthop Surg 2018; 26: e68–e76.
    1. Harisis GN, Lee JT, Clements W, Joseph T, Goh GS. Accuracy of dual‐bolus CT in the diagnosis of active arterial bleeding in adult pelvic trauma. J Med Imaging Radiat Oncol 2020; 64: 326–330.
    1. Tanizaki S, Maeda S, Matano H, Sera M, Nagai H, Ishida H. Time to pelvic embolization for hemodynamically unstable pelvic fractures may affect the survival for delays up to 60 min. Injury 2014; 45: 738–741.

Publication types

LinkOut - more resources