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Early experience with resuscitative endovascular balloon occlusion of the aorta for unstable pelvic fractures in the Republic of Korea: a multi-institutional study

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

Recently, trauma centers in the Republic of Korea introduced resuscitative endovascular balloon occlusion of the aorta (REBOA) for application in severe pelvic fracture cases. This study aimed to determine the efficacy of REBOA and its associated factors in enhancing survival.

Methods

Data from patients with severe pelvic injuries at two regional trauma centers from 2016 to 2020 were retrospectively reviewed. Patients were dichotomized into REBOA and no-REBOA groups, and patient characteristics and clinical outcomes were compared using 1:1 propensity score matching. Additional survival-based analysis was performed in the REBOA group.

Results

REBOA was performed in 42 of the 174 patients with pelvic fractures. As patients in the REBOA group had more severe injuries than did patients in the no-REBOA group, 1:1 propensity score matching was performed to adjust for severity. After matching, 24 patients were included in each group and mortality was not significantly different (REBOA 62.5% vs. no-REBOA 41.7%, P = 0.149). Kaplan–Meier analysis revealed no significant differences in mortality between the two matched groups (log-rank test, P = 0.408). Among the 42 patients treated with REBOA, 14 survived. Shorter REBOA duration (63 [40–93] vs. 166 [67–193] min, P = 0.015) and higher systolic blood pressure before REBOA (65 [58–76] vs. 54 [49–69] mmHg, P = 0.035) were associated with better survival.

Conclusions

The effectiveness of REBOA has not been definitively established; however, it was not associated with increased mortality in this study. Additional studies are required to better understand how REBOA can be effectively used for treatment.

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Funding

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Authors and Affiliations

  1. Division of Trauma Surgery, Department of Surgery, Dankook University College of Medicine, Cheonan, Republic of Korea

    Dong Hun Kim

  2. Division of Trauma Surgery, Department of Surgery, Ajou School of Medicine, 164 Worldcup-Ro, Yeongtong-Gu, Suwon-Si, Gyeonggi-Do, 16499, Republic of Korea

    Jonghwan Moon & Byung Hee Kang

  3. Department of Thoracic and Cardiovascular Surgery, Dankook University College of Medicine, Cheonan, Republic of Korea

    Sung Wook Chang

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  1. Dong Hun Kim
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Correspondence to Byung Hee Kang.

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The authors have no potential conflicts of interest to disclose.

Ethics statement

The study protocol was reviewed and approved by the institutional review boards of Ajou and Dankook University Hospitals (AJOUIRB-DB-2022-513/DKUH 2202-11-028), who waived the requirement for informed consent.

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Kim, D.H., Moon, J., Chang, S.W. et al. Early experience with resuscitative endovascular balloon occlusion of the aorta for unstable pelvic fractures in the Republic of Korea: a multi-institutional study. Eur J Trauma Emerg Surg 49, 2495–2503 (2023). https://doi.org/10.1007/s00068-023-02293-x

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  • DOI: https://doi.org/10.1007/s00068-023-02293-x

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