REBOA Use and Complications in Geriatric Trauma Patients: Insights From a Multicenter Database

Area of Science:

• Trauma Surgery
• Vascular Surgery
• Geriatric Medicine

Background:

• Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an emergent procedure for trauma patients.
• Limited data exists on REBOA use and outcomes in the geriatric population.
• Preexisting comorbidities in older adults may increase complication rates.

Purpose of the Study:

• To evaluate REBOA utilization and associated complications in geriatric trauma patients (≥ 65 years) compared to younger adults.
• To test the hypothesis that geriatric patients experience higher complication rates.

Main Methods:

• Analysis of the American Association for the Surgery of Trauma Aortic Occlusion for Resuscitation in Trauma and Acute Care Surgery registry.
• Stratification of adult trauma patients into geriatric (≥ 65 y) and younger (18-64 y) cohorts.
• Comparison of demographic data, injury severity, REBOA placement, occlusion time, and complication rates (acute kidney injury, access site issues, limb ischemia).

Main Results:

• No significant differences in Injury Severity Score (ISS), REBOA zone placement, or occlusion duration between groups.
• Similar rates of acute kidney injury between geriatric (21.7%) and younger (22.1%) patients.
• Significantly lower rate of extremity ischemia in geriatric patients (0%) compared to younger patients (3.7%).

Conclusions:

• Geriatric patients undergoing REBOA had a significantly lower incidence of extremity limb ischemia.
• This finding may be attributed to underlying comorbidities in the geriatric population.
• Further prospective research is warranted to explore this observation.