Abstract:
BACKGROUND:A common dilemma in the management of pelvic fractures is recognizing the presence of associated abdominal injury. The purpose of this study was to determine the association between initial therapeutic intervention (laparotomy or transcatheter arterial embolization (TAE)) and mortality. METHODS:This was a cohort study using the Japan Trauma Data Bank between 2004 and 2010, including blunt trauma patients with pelvic fractures and positive Focused Assessment with Sonography in Trauma (FAST) results. Eligible patients were restricted to those who underwent laparotomy or TAE/angiography as the initial therapeutic intervention. Crude and adjusted odds ratio (AOR) for in-hospital mortality were compared between the laparotomy first and TAE first groups (reference group). Multiple logistic regression analysis and propensity score adjusted analysis were used to adjust for clinically relevant confounders, including the severity of injury. RESULTS:Of the 317 participants, 123 patients underwent laparotomy first and 194 patients underwent TAE first. The two groups were similar in terms of age, although the laparotomy first group had higher mean Injury Severity Scores (ISS) and higher mean scores based on the abdominal Abbreviated Injury Scale (AIS), as well as lower mean pelvic AIS and systolic blood pressure (SBP). Half of the patients who were hypotensive (SBP < 90 mmHg) on arrival underwent TAE first. The laparotomy first group had a significantly higher crude in-hospital mortality (41% vs. 27%; P < 0.01). After adjusting for confounders, the choice of initial therapeutic intervention did not affect the in-hospital mortality (AOR, 1.20; 95% Confidence Interval (CI), 0.61-2.39). Even in the limited subgroup of hypotensive patients (SBP 66-89 mmHg and SBP < 65 mmHg subgroup), the effect was similar (AOR, 1.50; 95% CI, 0.56-4.05 and AOR, 1.05; 95% CI, 0.44-3.03). CONCLUSIONS:In Japan, laparotomy and TAE are equally chosen as the initial therapeutic intervention regardless of hemodynamic status. No significant difference was seen between the laparotomy first and TAE first groups regarding in-hospital mortality.
journal_name
Scand J Trauma Resusc Emerg Medauthors
Katsura M,Yamazaki S,Fukuma S,Matsushima K,Yamashiro T,Fukuhara Sdoi
10.1186/1757-7241-21-82subject
Has Abstractpub_date
2013-12-03 00:00:00pages
82issn
1757-7241pii
1757-7241-21-82journal_volume
21pub_type
杂志文章abstract::This paper describes a simple approach to emergency burr hole evacuation of extra-axial intracranial haematoma that can be used in the uncommon situation when life saving specialist neurosurgical intervention is not available. ...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 社论
doi:10.1186/1757-7241-20-24
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abstract:BACKGROUND:There are three different types of ambulance systems, all of which can manage the same secondary intensive care patient transport mission: road ambulance, rotor-wing ambulance, and fixed-wing ambulance. We hypothesized that costs for specific transport distances would differ between systems. We aimed to anal...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
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journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
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journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
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journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
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journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
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journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
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journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 社论
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journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章,多中心研究
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journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章,评审
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更新日期:2017-04-20 00:00:00
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journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
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journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/1757-7241-18-41
更新日期:2010-07-19 00:00:00
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journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
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journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章,评审
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journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-016-0225-4
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journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/1757-7241-17-61
更新日期:2009-11-27 00:00:00
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journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
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journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章,多中心研究
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journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
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journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章,评审
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journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
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journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-018-0480-7
更新日期:2018-02-01 00:00:00
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journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/1757-7241-20-80
更新日期:2012-12-17 00:00:00
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journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-018-0558-2
更新日期:2018-11-09 00:00:00
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journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/1757-7241-17-30
更新日期:2009-07-08 00:00:00
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journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-016-0279-3
更新日期:2016-06-29 00:00:00
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journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
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更新日期:2020-05-24 00:00:00
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journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/s13049-018-0515-0
更新日期:2018-06-19 00:00:00
abstract:BACKGROUND:The Utstein style for drowning (USFD) was published in 2003 with the aim of improving drowning research. To support a revision of the USFD, the current study aimed to generate an inventory of the use of the USFD parameters and compare the findings of the publications that have used the USFD. METHODS:A searc...
journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章,评审
doi:10.1186/s13049-018-0488-z
更新日期:2018-03-22 00:00:00
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journal_title:Scandinavian journal of trauma, resuscitation and emergency medicine
pub_type: 杂志文章
doi:10.1186/1757-7241-19-67
更新日期:2011-11-03 00:00:00