Predictors of Mortality from Spontaneous Soft-Tissue Hematomas in a Large Multicenter Cohort Who Underwent Percutaneous Transarterial Embolization
| Autor: | Olivier Pellerin, Anthony Dohan, Marc Sapoval, Louis-Martin Boucher, Matthias Barral, Vi Thuy Tran, Philippe Soyer, Benoit Gallix, David Valenti |
|---|---|
| Přispěvatelé: | Service de Radiologie [CHU Cochin], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Lariboisière-Fernand-Widal [APHP], Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), McGill University Health Center [Montreal] (MUHC), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre hospitalier Félix-Guyon [Saint-Denis, La Réunion], Service de radiologie cardio-vasculaire [CHU HEGP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO) |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Percutaneous [SDV.IB.IMA]Life Sciences [q-bio]/Bioengineering/Imaging medicine.medical_treatment 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Hematoma Muscular Diseases [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system medicine Humans Retroperitoneal space Radiology Nuclear Medicine and imaging Retroperitoneal Space Embolization Simplified Acute Physiology Score Aged Retrospective Studies Aged 80 and over business.industry Mortality rate Endovascular Procedures Retrospective cohort study Middle Aged medicine.disease Embolization Therapeutic 3. Good health Surgery MESH: Embolization Thrapeutic / methods Endovascular Procedures / adverse effects Hematoma / therapy Muscular Diseases / mortality Retrospective studies Treatment Outcome medicine.anatomical_structure SAPS II 030220 oncology & carcinogenesis Female business [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology |
| Zdroj: | Radiology Radiology, Radiological Society of North America, 2019, 291 (1), pp.250-258. ⟨10.1148/radiol.2018181187⟩ |
| ISSN: | 1527-1315 0033-8419 |
| Popis: | Purpose To evaluate the safety and efficacy of percutaneous transarterial embolization (PTAE) for the treatment of spontaneous soft-tissue hematomas (SSTHs) and identify variables predictive of short-term outcome. Materials and Methods Between 2011 and 2017, the outcome was retrospectively analyzed for 112 patients (mean age ± standard deviation, 72 years ± 14; range, 28-92 years), including 65 women (mean age, 73 years ± 12.7; range, 39-92 years) and 47 men (mean age, 70 years ± 14.9; range, 28-91 years), with SSTH treated with PTAE. Thirty-day mortality, technical and clinical success, simplified acute physiology score (SAPS) II, anticoagulation, embolic agent, hematoma volume and location, serum hemoglobin level, hemodynamic instability, and presence of active bleeding at CT and/or angiography were recorded. Clinical success was defined as cessation of bleeding as determined by hemodynamic stability and/or serum hemoglobin level stabilization after PTAE. Univariable and multivariable analyses were performed by using a Cox model to identify variables associated with time to death. Results Mortality rate was 26.8% (30 of 112 patients), angiographic success rate was 95.5% (107 of 112 patients), and clinical success rate was 83% (93 of 112 patients). For surviving patients, mean SAPS II was 19.6 ± 7.1 (range, 13-31) and mean hematoma volume was 862 cm3 ± 618 (range, 238-1887 cm3). For deceased patients, mean SAPS II was 42 ± 13.2 (range, 18-63) and mean hematoma volume was 1419 cm3 ± 788 (range, 251-3492 cm3). SAPS II (P < .001), hematoma volume (P = .01), and retroperitoneal location (P = .01) were independently associated with fatal outcome. Conclusion Percutaneous transarterial embolization is effective for the emergency treatment of spontaneous soft-tissue hematomas. Simplified acute physiology score II, hematoma volume, and retroperitoneal location are predictors of short-term outcome. © RSNA, 2019 Online supplemental material is available for this article. |
| Databáze: | OpenAIRE |
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