Angioembolization performed by trauma surgeons for trauma patients: is it feasible in Korea? A retrospective study.

Autor:	Kwon S; Department of Emergency Medicine, Jeju Regional Trauma Center, Cheju Halla General Hospital, Jeju, Korea., Kim K; Department of Trauma Surgery, Jeju Regional Trauma Center, Cheju Halla General Hospital, Jeju, Korea., Jeong ST; Department of Physical Medicine and Rehabilitation, Ansanhyo Hospital, Ansan, Korea., Kim J; Department of Trauma Surgery, Jeju Regional Trauma Center, Cheju Halla General Hospital, Jeju, Korea., Yeo K; Department of Trauma Surgery, Jeju Regional Trauma Center, Cheju Halla General Hospital, Jeju, Korea., Kwon O; Department of Trauma Surgery, Jeju Regional Trauma Center, Cheju Halla General Hospital, Jeju, Korea., Park SJ; Department of Trauma Surgery, Jeju Regional Trauma Center, Cheju Halla General Hospital, Jeju, Korea., Gwak J; Department of Trauma Surgery, Jeju Regional Trauma Center, Cheju Halla General Hospital, Jeju, Korea., Kang WS; Department of Trauma Surgery, Jeju Regional Trauma Center, Cheju Halla General Hospital, Jeju, Korea.
Jazyk:	angličtina
Zdroj:	Journal of trauma and injury [J Trauma Inj] 2024 Mar; Vol. 37 (1), pp. 28-36. Date of Electronic Publication: 2024 Jan 12.
DOI:	10.20408/jti.2023.0076
Abstrakt:	Purpose: Recent advancements in interventional radiology have made angioembolization an invaluable modality in trauma care. Angioembolization is typically performed by interventional radiologists. In this study, we aimed to investigate the safety and efficacy of emergency angioembolization performed by trauma surgeons. Methods: We identified trauma patients who underwent emergency angiography due to significant trauma-related hemorrhage between January 2020 and June 2023 at Jeju Regional Trauma Center. Until May 2022, two dedicated interventional radiologists performed emergency angiography at our center. However, since June 2022, a trauma surgeon with a background and experience in vascular surgery has performed emergency angiography for trauma-related bleeding. The indications for trauma surgeon-performed angiography included significant hemorrhage from liver injury, pelvic injury, splenic injury, or kidney injury. We assessed the angiography results according to the operator of the initial angiographic procedure. The term "failure of the first angioembolization" was defined as rebleeding from any cause, encompassing patients who underwent either re-embolization due to rebleeding or surgery due to rebleeding. Results: No significant differences were found between the interventional radiologists and the trauma surgeon in terms of re-embolization due to rebleeding, surgery due to rebleeding, or the overall failure rate of the first angioembolization. Mortality and morbidity rates were also similar between the two groups. In a multivariable logistic regression analysis evaluating failure after the first angioembolization, pelvic embolization emerged as the sole significant risk factor (adjusted odds ratio, 3.29; 95% confidence interval, 1.05-10.33; P=0.041). Trauma surgeon-performed angioembolization was not deemed a significant risk factor in the multivariable logistic regression model. Conclusions: Trauma surgeons, when equipped with the necessary endovascular skills and experience, can safely perform angioembolization. To further improve quality control, an enhanced training curriculum for trauma surgeons is warranted. Competing Interests: Conflicts of interest Wu Seong Kang is an Editorial Board member of the Journal of Trauma and Injury, but was not involved in in the peer reviewer selection, evaluation, or decision process of this article. The authors have no other conflicts of interest to declare. Data availability Data analyzed in this study are available from the corresponding author upon reasonable request. (© 2024 The Korean Society of Traumatology.)
Databáze:	MEDLINE
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