Angioembolization within 60 minutes for exsanguinating trauma patients: A meaningful metric with a definition gap

Standards on the time from the decision to deploy interventional radiology (IR) to its initiation was recently changed from 30 to 60 ​min, though supporting evidence remains unclear. We aimed to identify the association of IR timing standard compliance with outcomes among trauma patients.

This study examined adult trauma patients (≥16 years) requiring angioembolization, stratified by IR initiation within 60 ​min of emergency department discharge (IR60) and beyond. Multivariable regressions were used to evaluate associations of IR timing with clinical and financial outcomes. Variation attributable to hospital-level factors was also determined using multi-level models.

The study included 2793 patients, of which 38.3 ​% were IR60. All risk-adjusted outcomes were similar between the two cohorts. Additionally, notable variation in the proportion of IR60 was attributable to hospital-level factors.

Similar clinical outcomes between IR60 and non-IR60 question the validity of the current timing requirement for angioembolization in trauma patients.