Timely angiography and embolization is effective emergency treatment for severe post-traumatic pelvic fractures

Hemorrhage is a leading cause of death in patients with severe pelvic fractures, and angiography and embolization (AE) is a crucial intervention for controlling arterial bleeding associated with these injuries. However, there is a paucity of data regarding the impact of the time from injury to AE treatment (TIAE) on patient outcomes. This study investigates TIAE on outcomes in 161 patients with severe pelvic fractures, retrospectively analyzed from January 2019 to November 2024. Nonsurvivors exhibited a longer TIAE (19.9 ± 20.0 h) and higher Injury Severity Scores (ISSs) (39.4 ± 12.2) compared to survivors (11.1 ± 14.9 h and 28.4 ± 9.0, respectively). Age was not identified as a significant predictor of mortality (p = 0.795). Multivariate logistic regression confirmed ISS as an independent risk factor for mortality, while linear regression demonstrated a positive correlation between TIAE and both hospital and ICU stays, as well as transfusion volume. A significant reduction in the shock index was observed post-AE, particularly among patients receiving early AE, who also experienced lower mortality rates. This research underscores the importance of minimizing TIAE to enhance survival and improve clinical outcomes, highlighting the necessity for prompt AE in the emergency management of severe pelvic fractures.