J Acute Care Surg.
2024 Mar;14(1):16-26. 10.17479/jacs.2024.14.1.16.
Contemporary Utilization and Outcomes of Resuscitative Endovascular Balloon Occlusion of the Aorta for Traumatic Noncompressible Torso Hemorrhage in Korea: A Retrospective Multi-Center Study
- Affiliations
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- 1Division of Trauma Surgery, Department of Surgery, Dankook University College of Medicine, Cheonan, Republic of Korea
- 2Department of Trauma Surgery, Trauma Center, Dankook University Hospital, Cheonan, Republic of Korea
- 3Department of Thoracic and Cardiovascular Surgery, Trauma Center, Dankook University Hospital, Cheonan, Republic of Korea
- 4Department of Traumatology, Gachon University College of Medicine, Incheon, Republic of Korea
- 5Division of Trauma Surgery, Department of Surgery, Ajou School of Medicine, Suwon, Republic of Korea
- 6Department of Trauma and Acute Care Surgery, Yonsei University Wonju Severance Christian Hospital, Wonju, Republic of Korea
- 7Department of Trauma Surgery, Jeju Regional Trauma Center, Cheju Halla General Hospital, Jeju, Republic of Korea
- KMID: 2553582
- DOI: http://doi.org/10.17479/jacs.2024.14.1.16
Abstract
- Purpose
This study aimed to evaluate the utilization and outcomes of resuscitative endovascular balloon occlusion of the aorta (REBOA) in managing noncompressible torso hemorrhage (NCTH) among trauma patients in Korea. The evolution of REBOA and its impact on patient survival was investigated as well as predictors of mortality.
Methods
This retrospective study included 234 post-REBOA patients from 5 leading regional trauma centers across Korea between 2016 and 2021. Primary outcomes were in-hospital mortality, and secondary outcomes were various clinical parameters regarding REBOA, overall treatment flow, and complications. For comparative analyses, patients were dichotomized into in-hospital non-survivors or survivors. Then, generalized additive and linear regression models were used to evaluate the trend of in-hospital mortality.
Results
The overall in-hospital mortality was 65.4%. The survivors had a higher proportion of responders following REBOA (87.7% vs 62.7%, p < 0.001). Key variables influencing outcomes included total occlusion time, red blood cell transfusion volume within the first 24 hours, revised trauma score, and systolic blood pressure gap. These factors significantly correlated with mortality rates in multivariate logistic regression.
Conclusion
Over 6 years, survival rates for NCTH patients undergoing REBOA in Korea have shown improvement. Despite diverse REBOA protocols across institutions, the results underscore the need for continued research, standardized practices, and national quality control measures to further optimize patient outcome and establish more effective treatment protocols for NCTH.
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