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Published on: July 28, 2020
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Embolization versus Surgery for Stabilized Patients with Solid Organ Injury.
Makoto Aoki1, Toshikazu Abe2, Shuichi Hagiwara3
1Department of Emergency Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan; Department of Emergency and Critical Care Medicine, Saiseikai Yokohamashi Tobu Hospital, Kanagawa, Japan.
Summary
Embolization and laparotomy show similar in-hospital survival rates for hemodynamically unstable patients with solid organ injuries who respond to initial resuscitation. This study compared these two management strategies for trauma patients.
Area of Science:
- Trauma Surgery
- Interventional Radiology
- Emergency Medicine
Background:
- Hemodynamically unstable patients with solid organ injuries require prompt management.
- Initial resuscitation is crucial for patient stabilization.
- Computed tomography (CT) is used for diagnosing solid organ injuries.
Purpose of the Study:
- To compare the efficacy of embolization versus laparotomy in managing hemodynamically unstable patients with solid organ injuries.
- To evaluate in-hospital survival rates between the two treatment groups.
Main Methods:
- Analysis of a Japanese nationwide trauma registry data.
- Inclusion of hemodynamically unstable patients (systolic blood pressure <90 mm Hg) with confirmed liver and/or spleen injuries.
- Propensity score matching analysis to compare in-hospital survival between embolization and laparotomy groups.
Main Results:
- Laparotomy was performed in 133 patients, and embolization in 91 patients.
- In-hospital survival rates were 84% for laparotomy and 92% for embolization.
- No significant difference in in-hospital survival was found between the two groups (P = .053, P = .276 after propensity score matching).
Conclusions:
- Embolization and laparotomy demonstrate comparable in-hospital survival rates for hemodynamically unstable patients with solid organ injury who respond to initial resuscitation.
- The choice of management strategy may depend on other factors beyond survival.
- Further research may explore long-term outcomes and cost-effectiveness.
