American journal of surgery · 2025
Angioembolization within 60 minutes for exsanguinating trauma patients: A meaningful metric with a definition gap.
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Gao Zihan, Cho Nam Yong, Shen Aricia, Siena Nicholas, Coaston Troy N, Vadlakonda Amulya, Benharash Peyman, Barmparas Galinos, Academic Trauma Research Consortium (ATRIUM)
Аннотация
BACKGROUND: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSION: Similar clinical outcomes between IR60 and non-IR60 question the validity of the current timing requirement for angioembolization in trauma patients.
METHODS: 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.
RESULTS: 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.
CONCLUSION: Similar clinical outcomes between IR60 and non-IR60 question the validity of the current timing requirement for angioembolization in trauma patients.