Melanie Morote González (Madrid / ES), Laura Cebolla Rojas (Madrid / ES), Carlos Morales García (Madrid / ES), Maria Galindo Alins (Madrid / ES), Carlota Perez Carpio (Madrid / ES), Cristina Rey Valcárcel (Madrid / ES), María Dolores Pérez Díaz (Madrid / ES), Fernando Turégano Fuentes (Madrid / ES)
Abstract text (incl. references and figure legends)
INTRODUCTION
The use of angiography (AG) and angioembolization (AE) has tripled in the initial treatment of grade IV-V hepatosplenic injuries with hemodynamic stability or transient response, as well as in severe pelvic fractures with active bleeding. Likewise, we believe that it has been a decisive factor contributing to the decrease in morbidity and mortality.
MATERIAL & METHODS
Single-center observational retrospective study, patients included from a prospective severe trauma registr, with 3 periods of study: P1 (anecdotal use of AG), P2 (between its firm implantation and the establishment of a massive transfusion protocol), and P3 (after said protocol). Clinical success in the main locations has been understood as the absence of the need for reembolization, surgical intervention due to rebleeding, or death due to hemorrhage.
RESULTS
Between 1993 and 2021, 264 patients with severe trauma underwent AG: 39 in P1, 105 in P2, and 120 in P3. We have not found statistically significant differences in demographic variables compared between groups, nor in the mechanism of injury. The main indications for AG were hepatosplenic and pelvic injuries, intra and extra abdominal vascular injuries and retroperitoneal hematomas. 162 AE were performed (61.5%): 3 in P1(7%), 67 in P2(63.8%), and 92 in P3(76.7%). The clinical success rate was 85.3%. EA has managed to avoid 35 potential surgical approaches for pelvic fractures, 14 liver, 14 splenic, and 10 kidney surgeries, reducing the time from admission to surgical intervention from 15.5h in P1 to 147 min at P2 and 62 min at P3.Mortality from bleeding from hepatosplenic trauma has decreased from 2.6% to 0.7%, and from 4.9% to 2.6% in severe pelvic trauma.
CONCLUSIONS
The use of AG and AE has tripled in the initial treatment of grade IV-V hepatosplenic injuries and severe pelvic fractures with hemodynamic stability or transient response, being a decisive factor contributing to the decrease in morbidity and mortality.
Disclosure: Do you have a significant financial interest, consultancy or other relationship with products, manufacturer(s) of products or providers of services related to this abstract? (If not, please enter "No" in the text field.)
No