Angioembolization May Improve Survival in Patients With Severe Hepatic Injuries

Area of Science:

• Trauma Surgery
• Interventional Radiology
• Hepatobiliary Medicine

Background:

• Severe hepatic trauma management remains challenging.
• Angioembolization (AE) shows promise but its role in severe hepatic injuries needs further clarification.
• Understanding the impact of AE on mortality based on injury mechanisms is crucial.

Purpose of the Study:

• To determine the association between AE and in-hospital mortality in severe hepatic trauma.
• To investigate the influence of mechanisms of injury (MOI) on AE outcomes.
• To evaluate AE's effectiveness in different patient subgroups.

Main Methods:

• Retrospective analysis of 2462 patients with severe hepatic injuries (2013-2018).
• Data collected included demographics, MOI, shock index, blood transfusion, injury severity score (ISS), and AE use.
• Multivariable logistic regression analyzed mortality association with AE, controlling for covariates.

Main Results:

• AE was utilized in only 21% of severe hepatic trauma cases.
• Higher ISS and age correlated with increased mortality.
• AE was associated with mortality, with strongest links to ISS ≥25, ≥6 PRBCs/LOS, and age ≥65.

Conclusions:

• Angioembolization is underutilized in severe hepatic trauma.
• AE may be beneficial for older patients and those undergoing exploratory laparotomy.
• Further research is needed to optimize AE use in severe hepatic injuries.