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Updated: Aug 28, 2025

Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Angioembolization versus preperitoneal packing for severe pelvic fractures: A propensity matched analysis
Makoto Aoki1, Kazuhide Matsushima2, Shokei Matsumoto3
1Advanced Medical Emergency Department and Critical Care Center, Japan Red Cross Maebashi Hospital, Maebashi, Japan.
Background:
Whether AE or PPP would be associated with survival among hemodynamically unstable pelvic fracture remains controversial.
Study Design:
This is a retrospective cohort study using the American College of Surgeons Trauma Quality Improvement Program database from 2016 to 2018. Patients >16 years with a severe pelvic fracture (abbreviated injury scale 3-5) who underwent AE or PPP were recruited. The primary outcome was in-hospital survival. Data were evaluated using a propensity-score matching (PSM) analysis.
Results:
A total of 1123 patients met our inclusion criteria. Of these, AE and PPP were performed in 964 (85.8%) and 159 (14.2%) patients, respectively. Concomitant hemorrhage control laparotomy was performed in 25.6% and 82.4% of AE and PPP patients, respectively. In 220 PSM patients, the mortality rate between AE and PPP groups was not significantly different (30.9% vs. 38.2%, P = 0.321).
Conclusions:
Though patients' characteristics differed between AE and PPP groups, comparable propensity-matched patients with severe pelvic fractures showed no significant difference in in-hospital survival. PPP was more likely to be selected for severe pelvic fractures necessitating laparotomy.
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