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Factors associated with survival in adult trauma patients undergoing angiography with and without embolization across trauma centers in the United States

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Abstract

Introduction

Interventional angiography is increasingly utilized in trauma management for various injuries. Despite published guidelines by the Eastern Association for the Surgery of Trauma on the use of angiography, limited data exist on factors associated with outcomes in angiography procedures. This study examines factors associated with survival to hospital discharge in trauma patients undergoing angiography with or without embolization across US trauma centers.

Materials and methods

This retrospective observational study used the National Trauma Data Bank 2017 dataset and included adult trauma patients who underwent conventional angiography with or without embolization. A bivariate analysis was done to compare patients’ characteristics by outcome (survived/died), followed by a multivariable logistic regression analysis to determine factors associated with survival to hospital discharge after adjusting for important confounders.

Results

In the included sample of 4242 patients, median age was 41 years and male gender was predominant (72.6%). Overall mean time to angiography was 263.77 ± 750.19 min. Factors positively associated with survival included treatment at large facilities with over 401 beds (OR = 2.170; 95% CI, [1.277–3.685]), helicopter ambulance/fixed-wing transport (OR = 1.736; 95% CI, [1.325–2.275]), mild Glasgow Coma Scale (OR = 7.621; 95% CI, [5.868–9.898]) and moderate Glasgow Coma Scale (OR = 3.127; 95% CI, [2.080–4.701]), SBP ≥ 90 (OR = 1.516; 95% CI [1.199–1.916]), and spleen as embolization site (OR = 1.647; 95% CI [1.119–2.423]).

Conclusion

This nationwide study identified variables associated with survival in trauma patients who underwent angiography. These variables can serve in creating standardized risk stratification tools that could be incorporated into evidence-based guidelines for angiography candidates.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Author information

Authors and Affiliations

  1. Faculty of Medicine, American University of Beirut, Beirut, Lebanon

    Ghassan Bou Saba & Rana Bachir

  2. Department of Emergency Medicine, American University of Beirut Medical Center, P.O. Box 11-0236, Riad El Solh, Beirut, 1107 2020, Lebanon

    Romy Rahal & Mazen El Sayed

  3. Emergency Medical Services and Pre-Hospital Care Program, American University of Beirut Medical Center, Beirut, Lebanon

    Mazen El Sayed

Authors
  1. Ghassan Bou Saba
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  2. Romy Rahal
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  3. Rana Bachir
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  4. Mazen El Sayed
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Contributions

GB and RR equally contributed to the manuscript. GB, RR, and RB acquired, analyzed, and drafted the work. ME conceived, designed, and substantively revised the study. GB, RR, RB, and ME approved the submitted version and agreed to be personally accountable.

Corresponding author

Correspondence to Mazen El Sayed.

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The Institutional Review Board (IRB) at the American University of Beirut approved this study.

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The authors declare no competing interests.

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Bou Saba, G., Rahal, R., Bachir, R. et al. Factors associated with survival in adult trauma patients undergoing angiography with and without embolization across trauma centers in the United States. Emerg Radiol 30, 1–10 (2023). https://doi.org/10.1007/s10140-022-02094-6

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  • DOI: https://doi.org/10.1007/s10140-022-02094-6

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