腹膜外盆腔填塞在孤立性严重骨盆骨折中与更高的死亡率和静脉血栓栓塞相关：一项匹配队列研究。
Preperitoneal pelvic packing in isolated severe pelvic fractures is associated with higher mortality and venous thromboembolism: A matched-cohort study.
机构信息
LA General Medical Center and University of Southern California, United States.
LA General Medical Center and University of Southern California, United States.
出版信息
Am J Surg. 2024 Oct;236:115828. doi: 10.1016/j.amjsurg.2024.115828. Epub 2024 Jul 3.
INTRODUCTION
Preperitoneal pelvic packing (PPP) has been advocated as a damage control procedure for pelvic fracture bleeding, despite of weak evidence.
METHODS
Matched cohort study, TQIP database. Patients with isolated severe blunt pelvic fractures (pelvis abbreviated injury score [AIS] ≥ 3, AIS ≤2 in all other body regions) were included. Patients who underwent PPP were matched to patients with no PPP, 1:3 nearest propensity score. Matching was performed based on demographics, vital signs on admission, comorbidities, injury characteristics, type and timing of initiation of VTE prophylaxis, and additional procedures including laparotomy, REBOA, and angioembolization.
RESULTS
64 patients with PPP were matched with 182 patients with No-PPP. PPP patients had higher in-hospital mortality (14.1 % vs 2.2 % p < 0.001) and higher rates of VTE and DVT (VTE: 14.1 % vs 4.4 % p = 0.018, DVT: 10.9 % vs 2.2 % p = 0.008).
CONCLUSION
PPP is associated with worse survival outcomes and increased rate of VTE and DVT complications.
简介
尽管证据不足，前腹膜盆腔填塞（PPP）已被提倡作为骨盆骨折出血的损伤控制措施。
方法
配对队列研究，TQIP 数据库。纳入孤立性严重钝性骨盆骨折患者（骨盆损伤严重程度评分[简明损伤评分法]≥3，所有其他身体区域简明损伤评分法≤2）。将行 PPP 的患者与未行 PPP 的患者进行配对，按 1:3 最近倾向评分匹配。匹配基于人口统计学、入院时生命体征、合并症、损伤特征、VTE 预防措施的类型和时机，以及包括剖腹术、REBOA 和血管栓塞术在内的其他程序。
结果
64 例 PPP 患者与 182 例无-PPP 患者匹配。PPP 患者的院内死亡率更高（14.1%比 2.2%，p<0.001），VTE 和 DVT 的发生率也更高（VTE：14.1%比 4.4%，p=0.018，DVT：10.9%比 2.2%，p=0.008）。
结论
PPP 与较差的生存结果和更高的 VTE 和 DVT 并发症发生率相关。
Zotero 插件