High-grade liver injuries with contrast extravasation managed initially with interventional radiology versus observation: A secondary analysis of a WTA multicenter study

被引：1

作者：

Aryan, Negaar ^{[1
]}

Grigorian, Areg ^{[1
]}

Tay-Lasso, Erika ^{[1
]}

Cripps, Michael ^{[2
]}

Carmichael, Heather ^{[2
]}

McIntyre, Robert, Jr. ^{[2
]}

Urban, Shane ^{[2
]}

Velopulos, Catherine ^{[2
]}

Burlew, Clay Cothren ^{[2
]}

Ballow, Shana ^{[3
]}

Dirks, Rachel C. ^{[3
]}

Lariccia, Aimee ^{[4
]}

Farrell, Michael S. ^{[5
,7
]}

Stein, Deborah M. ^{[6
,7
]}

Truitt, Michael S.

Verner, Heather M. Grossman

Mentzer, Caleb J. ^{[8
]}

Mack, T. J. ^{[8
]}

Ball, Chad G. ^{[9
]}

Mukherjee, Kaushik ^{[10
]}

Mladenov, Georgi ^{[10
]}

Haase, Daniel J. ^{[11
]}

Abdou, Hossam ^{[11
]}

Schroeppel, Thomas J. ^{[12
]}

Rodriquez, Jennifer ^{[12
]}

Bala, Miklosh ^{[13
]}

Keric, Natasha ^{[14
]}

Crigger, Morgan ^{[14
]}

Dhillon, Navpreet K. ^{[15
]}

Ley, Eric J. ^{[15
]}

Egodage, Tanya ^{[16
]}

Williamson, John ^{[16
]}

Cardenas, Tatiana CP. ^{[17
]}

Eugene, Vadine ^{[17
]}

Patel, Kumash ^{[18
]}

Costello, Kristen ^{[18
]}

Bonne, Stephanie ^{[19
]}

Elgammal, Fatima S. ^{[19
]}

Dorlac, Warren ^{[20
]}

Pederson, Claire ^{[20
]}

Werner, Nicole L. ^{[21
]}

Haan, James M. ^{[22
]}

Lightwine, Kelly ^{[22
]}

Semon, Gregory ^{[23
]}

Spoor, Kristen ^{[24
]}

Harmon, Laura A. ^{[25
]}

Samuels, Jason M. ^{[26
]}

Spalding, M. C. ^{[27
]}

Nahmias, Jeffry ^{[1
]}

机构：

[1] Univ Calif Irvine, Dept Surg, Div Trauma Burns & Surg Crit Care, Irvine, CA 92868 USA

[2] UCH Hosp Anschutz Med Campus, Aurora, CO USA

[3] Univ Calif San Francisco, Fresno, CA USA

[4] Grant Med Ctr, Columbus, OH USA

[5] Lehigh Valley Hlth Network, Allentown, PA USA

[6] Univ Maryland Sch Med, R Adams Cowley Shock Trauma Ctr, Baltimore, MD USA

[7] Methodist Dallas Med Ctr, Dallas, TX USA

[8] Spartanburg Reg Med Ctr, Spartanburg, SC USA

[9] Univ Calgary, Calgary, AB, Canada

[10] Loma Linda Univ Hlth, Div Acute Care Surg, Loma Linda, CA USA

[11] Univ Maryland, Sch Med, Dept Emergency Med & Surg, R Adams Cowley Shock Trauma Ctr, Baltimore, MD USA

[12] UCHlth Mem Hosp, Colorado Springs, CO USA

[13] Hadassah Med Ctr, Jerusalem, Israel

[14] Banner Univ, Med Ctr, Phoenix, AZ USA

[15] Cedars Sinai Med Ctr, Los Angeles, CA USA

[16] Cooper Univ Hlth Care, Camden, NJ USA

[17] Univ Texas Austin, Dell Med Sch, Austin, TX USA

[18] Banner Thunderbird Med Ctr, Anthem, AZ USA

[19] Rutgers New Jersey Med Sch, Dept Surg, Div Trauma & Surg Crit Care, Newark, NJ USA

[20] Med Ctr Rockies, Loveland, CO 80538 USA

[21] Univ Wisconsin Madison, Sch Med & Publ Hlth, Madison, WI USA

[22] Ascens Via Christi St Francis, Dept Trauma Serv, Wichita, KS USA

[23] Wright State Univ, Miami Valley Hosp, Dayton, OH USA

[24] Prisma Hlth, Sumter, SC USA

[25] Boulder Community Hosp, Boulder, CO USA

[26] Vanderbilt Univ Sch Med, Sect Surg Sci, Nashville, TN USA

[27] Mt Carmel East, Grant Med Ctr, Div Trauma & Acute Care Surg, Columbus, OH USA

来源：

AMERICAN JOURNAL OF SURGERY | 2024年 / 234卷

关键词：

High-grade liver injury; Observational management; Abdominal trauma; Angiography; HEPATIC ARTERIAL EMBOLIZATION; NONOPERATIVE MANAGEMENT; TRAUMA; ANGIOEMBOLIZATION; OUTCOMES; ASSOCIATION; SURGERY; NEED; IV;

D O I：

10.1016/j.amjsurg.2024.03.018

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Background: High-grade liver injuries with extravasation (HGLI + Extrav) are associated with morbidity/mortality. For low-grade injuries, an observation (OBS) first-strategy is beneficial over initial angiography (IR), however, it is unclear if OBS is safe for HGLI + Extrav. Therefore, we evaluated the management of HGLI + Extrav patients, hypothesizing IR patients will have decreased rates of operation and mortality. Methods: HGLI + Extrav patients managed with initial OBS or IR were included. The primary outcome was need for operation. Secondary outcomes included liver-related complications (LRCs) and mortality. Results: From 59 patients, 23 (39.0%) were managed with OBS and 36 (61.0%) with IR. 75% of IR patients underwent angioembolization, whereas 13% of OBS patients underwent any IR, all undergoing angioembolization. IR patients had an increased rate of operation (13.9% vs. 0%, p = 0.049), but no difference in LRCs (44.4% vs. 43.5%) or mortality (5.6% vs. 8.7%) versus OBS patients (both p > 0.05). Conclusion: Over 60% of patients were managed with IR initially. IR patients had an increased rate of operation yet similar rates of LRCs and mortality, suggesting initial OBS reasonable in appropriately selected HGLI + Extrav patients.

引用

页码：105 / 111

页数：7

共 1 条

[1] Association of Contrast Extravasation Grade With Massive Transfusion in Pediatric Blunt Liver and Spleen Injuries: A Multicenter Retrospective Cohort Study
Katsura, Morihiro
Fukuma, Shingo
Kuriyama, Akira
Kondo, Yutaka
Yasuda, Hideto
Matsushima, Kazuhide
Shiraishi, Atsushi
Kusaka, Akari
Nakabayashi, Yosuke
Yagi, Masayuki
Ito, Fumihito
Tanikawa, Atsushi
Kushimoto, Shigeki
JOURNAL OF PEDIATRIC SURGERY, 2024, 59 (03) : 500 - 508

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