1 Department of Radiology, University of Washington School of Medicine, 325 Ninth Ave, Box 357115, Seattle, WA 98195-7115.
AJR Am J Roentgenol. 2014 Jun;202(6):W580-5. doi: 10.2214/AJR.13.11216.
The objective of our study was to evaluate the long-term trends in the use of angiography and embolization for abdominopelvic injuries.
Utilization rates for pelvic and abdominal angiography, arterial embolization, and CT were analyzed for trauma patients with pelvic fractures and liver and kidney injuries admitted to a level 1 trauma center from 1996 to 2010. Multivariable linear regression was used to evaluate trends in the use of angioembolization.
A total of 9145 patients were admitted for abdominopelvic injuries during the study period. Pelvic angiography decreased annually by 5.0% (95% CI, -6.4% to -3.7%) from 1996 to 2002 and by 1.8% (-2.4% to -1.2%) from 2003 to 2010. Embolization rates for these patients varied from 49% in 1997 to 100% in 2010. Utilization of pelvic CT on the day of admission increased significantly during this period. Abdominal angiography for liver and kidney injuries decreased annually by 3.3% (95% CI, -4.8% to -1.8%) and 2.0% (-4.3% to 0.3%) between 1996 and 2002 and by 0.8% (95% CI, -1.4% to -0.1%) and 0.9% (-2.0% to 0.1%) from 2003 to 2010, respectively. Embolization rates ranged from 25% in 1999 to 100% in 2010 for liver injuries and from 0% in 1997 to 80% in 2002 for kidney injuries. Abdominal CT for liver and kidney injuries on the day of admission also increased.
A significant decrease in angiography use for trauma patients with pelvic fractures, liver injuries, and kidney injuries from 1996 to 2010 and a trend toward increasing embolization rates among patients who underwent angiography were found. These findings reflect a declining role of angiography for diagnostic purposes and emphasize the importance of angiography as a means to embolization for management.
我们的研究目的是评估腹部骨盆损伤血管造影和栓塞的长期趋势。
对 1996 年至 2010 年期间因骨盆骨折和肝、肾损伤入住 1 级创伤中心的创伤患者的骨盆和腹部血管造影、动脉栓塞和 CT 的使用率进行了分析。多变量线性回归用于评估血管栓塞使用趋势。
在研究期间，共有 9145 例患者因腹部骨盆损伤入院。从 1996 年至 2002 年，骨盆血管造影的年使用率下降了 5.0%（95%可信区间，-6.4%至-3.7%），从 2003 年至 2010 年，年使用率下降了 1.8%（-2.4%至-1.2%）。这些患者的栓塞率在 1997 年从 49%到 2010 年增加到 100%。在此期间，入院当天骨盆 CT 的使用率显著增加。肝、肾损伤的腹部血管造影的年使用率分别下降了 3.3%（95%可信区间，-4.8%至-1.8%）和 2.0%（95%可信区间，-4.3%至 0.3%），从 1996 年至 2002 年，分别下降了 0.8%（95%可信区间，-1.4%至-0.1%）和 0.9%（95%可信区间，-2.0%至 0.1%）。栓塞率在 1999 年从 25%增加到 2010 年的 100%，在 1997 年为 0%，在 2002 年增加到 80%。入院当天的肝、肾损伤的腹部 CT 也有所增加。
从 1996 年至 2010 年，骨盆骨折、肝损伤和肾损伤患者的血管造影使用率显著下降，接受血管造影的患者栓塞率呈上升趋势。这些发现反映了血管造影在诊断目的方面的作用下降，并强调了血管造影作为治疗手段的栓塞的重要性。
