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Burton H, Mossadegh S, McCarthy R. Hockey: a pain in the butt! Isolated superior gluteal artery rupture following blunt pelvic trauma - an unusual case. Ann R Coll Surg Engl 2021; 103:e91-e93. [PMID: 33645276 DOI: 10.1308/rcsann.2020.7045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Superior gluteal artery rupture is a rare complication of trauma but a significant one with potential for substantial morbidity and mortality. This case demonstrates the importance of early diagnosis and treatment of this injury pattern. Endovascular embolisation has become the most effective treatment for pelvic haemorrhage. Acknowledgement of this rare injury as a differential diagnosis is vital to facilitate rapid diagnosis and appropriate treatment.
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Affiliation(s)
- H Burton
- Royal Devon and Exeter Hospital, Exeter, UK
| | | | - R McCarthy
- Royal Devon and Exeter Hospital, Exeter, UK
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Kim H, Jeon CH, Kim JH, Sun HW, Ryu D, Lee KH, Park CI, Jang JH, Park SJ, Yeom SR. Transarterial embolisation is associated with improved survival in patients with pelvic fracture: propensity score matching analyses. Eur J Trauma Emerg Surg 2020; 47:1661-1669. [PMID: 32949247 PMCID: PMC8629886 DOI: 10.1007/s00068-020-01497-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 09/08/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Transarterial embolisation (TAE) is an effective intervention for management of arterial haemorrhage associated with pelvic fracture. However, its effects on survival and clinical outcomes are unclear. METHODS Trauma patients with survival data between November 2015 and December 2019 were identified using a trauma database. Patients were divided between TAE and non-TAE groups, and a propensity score was developed using multivariate logistic regression. Survival at 28 days was compared between the groups after propensity score matching. RESULTS Among 881 patients included in this study, 308 (35.0%) were treated with TAE. After propensity score matching, 130 pairs were selected. Survival at 28 days was significantly higher among patients treated with TAE than among those treated without TAE [122 (93.9%) vs. 112 (86.2%); odds ratio = 2.45; 95% CI 1.02-5.86; p = 0.039]. CONCLUSIONS TAE use was associated with improved survival at 28 days in patients with pelvic fracture and should therefore be considered in the management of severely injured patients with pelvic fracture.
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Affiliation(s)
- Hohyun Kim
- Department of Trauma and Surgical Critical Care, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, Busan, 602-739, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.,Pusan National University School of Medicine, Yangsan, Korea
| | - Chang Ho Jeon
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.,Pusan National University School of Medicine, Yangsan, Korea.,Department of Diagnostic Radiology, Pusan National University Hospital, Busan, Korea
| | - Jae Hun Kim
- Department of Trauma and Surgical Critical Care, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, Busan, 602-739, Korea. .,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea. .,Pusan National University School of Medicine, Yangsan, Korea.
| | - Hyun-Woo Sun
- Department of Trauma and Surgical Critical Care, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, Busan, 602-739, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Dongyeon Ryu
- Department of Trauma and Surgical Critical Care, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, Busan, 602-739, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Kang Ho Lee
- Department of Trauma and Surgical Critical Care, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, Busan, 602-739, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Chan Ik Park
- Department of Trauma and Surgical Critical Care, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, Busan, 602-739, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Jae Hoon Jang
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.,Pusan National University School of Medicine, Yangsan, Korea.,Department of Orthopaedic Surgery, Pusan National University Hospital, Busan, Korea
| | - Sung Jin Park
- Department of Trauma and Surgical Critical Care, Pusan National University Hospital, 179 Gudeok-Ro, Seo-Gu, Busan, 602-739, Korea.,Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Seok Ran Yeom
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.,Pusan National University School of Medicine, Yangsan, Korea.,Department of Emergency Medicine, Pusan National University Hospital, Busan, Korea
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Yang Q, Wang T, Ai L, Jiang K, Tao X, Gong D, Chen N, Fu Y, Pan F. Clinical outcomes of blood transfusion to patients with pelvic fracture in the initial 6 h from injury. Exp Ther Med 2020; 19:2252-2258. [PMID: 32104291 PMCID: PMC7027319 DOI: 10.3892/etm.2020.8445] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 12/02/2019] [Indexed: 11/06/2022] Open
Abstract
As part of the treatment of pelvic fracture, major hemorrhage poses a challenge for trauma surgeons. The aim of the present study was to evaluate the clinical outcomes of blood transfusion in the initial 6 h after pelvic fracture, and to define the blood transfusion volume required for each pelvic fracture type. A retrospective cohort study was performed on patients with pelvic fracture at a single Level I Trauma Centre over a 3-year period. A total of 1,297 patients were transported to our trauma centre within 2 h of injury and blood transfusion was administered in the initial 6 h after pelvic fracture. Review of the patients' medical records provided the initial pelvic radiographs and data from emergency department care. Clinical outcomes, including frequency of blood transfusion, blood transfusion volume, injury severity scores and mortality, were evaluated. All pelvic fractures were defined as closed fractures and patients were categorized according to the Arbeit fuer Osteosynthese (AO) classification system. Statistical methods were used to identify trends to provide guidance for clinical prediction. Complete data were available for 497 patients with pelvic fracture, 104 (20.9%) of which received blood transfusion. The blood transfusion volume in the initial 6 h ranged from 0 to 10,000 ml, with a mean of 1,213.94±1354.11 ml. The total mortality rate was 1.8%. Among the patients with C-type pelvic fractures, the frequency of blood transfusion was 59.0% and the mean volume was 2,191.30±1,740.93 ml. The mortality rate for C-type pelvic fractures was 11.43%. The B3 subtype of pelvic fractures had the highest transfusion frequency (53.6%), while the C3 subtype had the largest blood transfusion volume (5,700.00±4,666.90 ml). Patients with type A-C pelvic fractures had a progressively larger mean transfusion volume, transfusion frequency and mortality in the initial 6 h after pelvic fracture. The AO classification system was demonstrated to be a useful tool for the identification of pelvic fracture risk in the present study.
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Affiliation(s)
- Qing Yang
- Department of Orthopedics, QingPu Branch of Zhongshan Hospital Affiliated to Fudan University, Qingpu District Central Hospital of Shanghai, Shanghai 201700, P.R. China
| | - Ting Wang
- Department of Gastroenterology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai 201600, P.R. China
| | - Lei Ai
- Department of Laboratory, Taishan Coal Sanatorium, Taian, Shangdong 201700, P.R. China
| | - Kai Jiang
- Department of Orthopedics, QingPu Branch of Zhongshan Hospital Affiliated to Fudan University, Qingpu District Central Hospital of Shanghai, Shanghai 201700, P.R. China
| | - Xingguang Tao
- Department of Orthopedics, QingPu Branch of Zhongshan Hospital Affiliated to Fudan University, Qingpu District Central Hospital of Shanghai, Shanghai 201700, P.R. China
| | - Dongliang Gong
- Department of Orthopedics, QingPu Branch of Zhongshan Hospital Affiliated to Fudan University, Qingpu District Central Hospital of Shanghai, Shanghai 201700, P.R. China
| | - Nong Chen
- Department of Orthopedics, QingPu Branch of Zhongshan Hospital Affiliated to Fudan University, Qingpu District Central Hospital of Shanghai, Shanghai 201700, P.R. China
| | - Yang Fu
- Department of Orthopedics, QingPu Branch of Zhongshan Hospital Affiliated to Fudan University, Qingpu District Central Hospital of Shanghai, Shanghai 201700, P.R. China
| | - Fugen Pan
- Department of Orthopedics, QingPu Branch of Zhongshan Hospital Affiliated to Fudan University, Qingpu District Central Hospital of Shanghai, Shanghai 201700, P.R. China
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