Time to pelvic embolization for hemodynamically unstable pelvic fractures may affect the survival for delays up to 60 min

Abstract

Introduction: We evaluated the relationship between survival and time from arrival to angiography for hemodynamically unstable patients with pelvic trauma.

Methods: A retrospective review of patients admitted to Fukui Prefectural Hospital with pelvic fractures during a 7.5-year period. Charts were reviewed for age, injury characteristics, injury severity score, systolic blood pressure and heart rate on arrival, base deficit, and the lactate concentration on arrival, transfusion requirement, fracture pattern, the time from hospital arrival to angiography, and the time spent in the angiography suite.

Results: Of a total of 140 patients, 68 patients underwent pelvic angiography and embolization. Of the patients, 24 patients were hemodynamically unstable. The average injury severity score was 41.7. Of the patients, 17 had major ligamentous disruption. The average time from hospital arrival to angiography suite was 76 min. Of the hemodynamically unstable 24 patients, there were 12 deaths (50%). Patients who were embolized within 60 min of arrival had a significantly lower mortality rate (16 vs. 64%; p=0.04). There was no embolization-related complication and repeat angiography was not required in all patients.

Conclusion: Earlier pelvic embolization within 60 min may affect the survival of hemodynamically unstable patients with pelvic fracture.

Keywords: Angiography; Embolization; Pelvic trauma.