Outcomes of resuscitative endovascular balloon occlusion of
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Hemorrhage remains a leading cause of death among trauma patients. Resuscitative endovascular balloon occlusion of the aorta (REBOA) has grown in popularity as an efficient, less invasive alternative to manage patients with non-compressible hemorrhage. Inpatient mortality with REBOA use does not differ between patients with or without concomitant traumatic brain injury, states a new study.

The aim of this study by the Surgery was to investigate the clinical outcomes of resuscitative endovascular balloon occlusion of the aorta use in adult civilian trauma patients with and without concomitant traumatic brain injury.

This a secondary analysis of the American College of Surgeons Trauma Quality Improvement Program database of adult trauma patients with and without traumatic brain injury and who had a resuscitative endovascular balloon occlusion of the aorta. Patients who were deceased on arrival required resuscitative thoracotomy, or had missing information regarding traumatic brain injury status were excluded. Multivariable risk adjustment was performed. The primary outcome was inpatient mortality.

Of 2352542 patients, 199 met the criteria for inclusion in the final analysis.

--Resuscitative endovascular balloon occlusion of the aorta plus traumatic brain injury patients were significantly more likely to have a lower Glasgow Coma Scale ?8 and systolic blood pressure, and higher injury severity score >25 compared with resuscitative endovascular balloon occlusion of the aorta/non-traumatic brain injury patients.

--No differences in odds of inpatient mortality or complications were observed between groups.

--Subgroup analysis based on mechanism of injury, trauma center level, teaching hospital status, and pelvic fracture status also did not show any differences in mortality.

Conclusively, inpatient mortality with resuscitative endovascular balloon occlusion of the aorta use does not differ between patients with or without concomitant traumatic brain injury, despite those with traumatic brain injury having significantly higher injury severity and more severe hypotension on intake.

Source: https://doi.org/10.1016/j.surg.2021.01.043
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