Dataset Information

Relationship between in-hospital mortality and abdominal angiography among patients with blunt liver injuries: a propensity score-matching from a nationwide trauma registry of Japan.

ABSTRACT:

Aim

To assess relationships between abdominal angiography and outcomes in adults with blunt liver injuries.

Methods

A retrospective observational study carried out from January 2004 to December 2018. Adult blunt-trauma patients with AAST grade Ⅲ-Ⅴ were analyzed with in-hospital mortality as the primary outcome using propensity-score-(PS) matching to seek associations with abdominal angiography findings.

Results

A total of 1,821 patients were included, of which 854 had available abdominal angiography data (AA+) and 967 did not (AA-). From these, 562 patients were selected from each group by propensity score matching. In-hospital mortality was found to be lower in the AA+ than in the AA- group (15.1% [87/562] versus 25.4% [143/562]; odds ratio 0.544, 95% confidence interval 0.398-0.739).

Conclusion

Abdominal angiography is shown to be of benefit for adult patients with blunt liver injury in terms of their lower in-hospital mortality.

SUBMITTER: Ishida K

PROVIDER: S-EPMC8757632 | biostudies-literature | 2022 Jan-Dec

REPOSITORIES: biostudies-literature

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Publications

Relationship between in-hospital mortality and abdominal angiography among patients with blunt liver injuries: a propensity score-matching from a nationwide trauma registry of Japan.

Ishida Kenichiro K Katayama Yusuke Y Kitamura Tetsuhisa T Hirose Tomoya T Ojima Masahiro M Nakao Shunichiro S Tachino Jotaro J Umemura Yutaka Y Kiguchi Takeyuki T Matsuyama Tasuku T Noda Tomohiro T Kiyohara Kosuke K Shimazu Takeshi T Ohnishi Mitsuo M

Acute medicine & surgery 20220113 1

<h4>Aim</h4>To assess relationships between abdominal angiography and outcomes in adults with blunt liver injuries.<h4>Methods</h4>A retrospective observational study carried out from January 2004 to December 2018. Adult blunt-trauma patients with AAST grade Ⅲ-Ⅴ were analyzed with in-hospital mortality as the primary outcome using propensity-score-(PS) matching to seek associations with abdominal angiography findings.<h4>Results</h4>A total of 1,821 patients were included, of which 854 had avail ...[more]

PMID: 35059219

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Project description:BackgroundAlthough the results of previous studies suggested the effectiveness of physician-led prehospital trauma management, it has been uncertain because of the limited number of high-quality studies. Furthermore, the advantage of physician-led prehospital management might have been overestimated due to the shortened prehospital time by helicopter transportation in some studies. The present study aimed to evaluate the effect of physician-led prehospital management independent of prehospital time. Also, subgroup analysis was performed to explore the subpopulation that especially benefit from physician-led prehospital management.MethodsThis retrospective cohort study analyzed the data of Japan's nationwide trauma registry. Severe blunt trauma patients, defined by Injury Severity Score (ISS) ≥16, who were transported directly to a hospital between April 2009 and March 2019 were evaluated. In-hospital mortality was compared between groups dichotomized by the occupation of primary prehospital healthcare provider (i.e., physician or paramedic), using 1:4 propensity score-matched analysis. The propensity score was calculated using potential confounders including patient demographics, mechanism of injury, vital signs at the scene of injury, ISS, and total time from injury to hospital arrival. Subpopulations that especially benefit from physician-led prehospital management were explored by assessing interaction effects between physician-led prehospital management and patient characteristics.ResultsA total of 30,551 patients (physician-led: 2976, paramedic-led: 27,575) were eligible for analysis, of whom 2690 propensity score-matched pairs (physician-led: 2690, paramedic-led: 10,760) were generated and compared. Physician-led group showed significantly decreased in-hospital mortality than paramedic-led group (in-hospital mortality: 387 [14.4%] and 1718 [16.0%]; odds ratio [95% confidence interval] = 0.88 [0.78-1.00], p = 0.044). Patients with age < 65 years, ISS ≥25, Abbreviated Injury Scale in pelvis and lower extremities ≥3, and total prehospital time < 60 min were likely to benefit from physician-led prehospital management.ConclusionsPhysician-led prehospital trauma management was significantly associated with reduced in-hospital mortality independent of prehospital time. The findings of exploratory subgroup analysis would be useful for the future research to establish efficient dispatch system of physician team.

Dataset Information

Relationship between in-hospital mortality and abdominal angiography among patients with blunt liver injuries: a propensity score-matching from a nationwide trauma registry of Japan.

Aim

Methods

Results

Conclusion

Publications

Relationship between in-hospital mortality and abdominal angiography among patients with blunt liver injuries: a propensity score-matching from a nationwide trauma registry of Japan.

Similar Datasets

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