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Tytuł:
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A modern, multicenter evaluation of hepatic angioembolization - Complications and readmissions persist.
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Autorzy:
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Samuels JM; Division of GI, Trauma, and Endocrine Surgery, Department of Surgery, University of Colorado School of Medicine, 12636 East 17th Ave, Room 5401, Aurora, CO, 80045, USA. Electronic address: .
Urban S; Trauma Services, University of Colorado Hospital, Mail Stop-F756, 12401 E 17th Ave Aurora, CO, 80045, USA. Electronic address: .
Peltz E; Division of GI, Trauma, and Endocrine Surgery, Department of Surgery, University of Colorado School of Medicine, 12636 East 17th Ave, Room 5401, Aurora, CO, 80045, USA. Electronic address: .
Schroeppel T; Department of Surgery, UC Health Memorial Hospital, 1400 E. Boulder Street, Suite 600, Colorado Springs, CO, 80909, USA. Electronic address: .
Heise H; Department of Surgery, UC Health Memorial Hospital, 1400 E. Boulder Street, Suite 600, Colorado Springs, CO, 80909, USA. Electronic address: .
Dorlac WC; Department of Surgery, UC Health Medical Center of the Rockies, 2500 Rocky Mountain Avenue, Suite 2200 Loveland, CO, 80538, USA. Electronic address: .
Britton LJ; Department of Surgery, UC Health Medical Center of the Rockies, 2500 Rocky Mountain Avenue, Suite 2200 Loveland, CO, 80538, USA. Electronic address: .
Burlew CC; Division of GI, Trauma, and Endocrine Surgery, Department of Surgery, University of Colorado School of Medicine, 12636 East 17th Ave, Room 5401, Aurora, CO, 80045, USA; Department of Surgery, Denver Health Medical Center, 700 Delaware St., Davis Pavilion, Pavilion D & E Denver, CO, 80204, USA. Electronic address: .
Robinson C; Department of Surgery, Denver Health Medical Center, 700 Delaware St., Davis Pavilion, Pavilion D & E Denver, CO, 80204, USA. Electronic address: .
Swope ML; Department of Surgery, Denver Health Medical Center, 700 Delaware St., Davis Pavilion, Pavilion D & E Denver, CO, 80204, USA. Electronic address: .
McIntyre RC Jr; Division of GI, Trauma, and Endocrine Surgery, Department of Surgery, University of Colorado School of Medicine, 12636 East 17th Ave, Room 5401, Aurora, CO, 80045, USA. Electronic address: .
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Źródło:
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American journal of surgery [Am J Surg] 2020 Jan; Vol. 219 (1), pp. 117-122. Date of Electronic Publication: 2019 Jun 26.
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Typ publikacji:
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Journal Article; Multicenter Study
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Język:
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English
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Imprint Name(s):
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Publication: Belle Mead, NJ : Excerpta Medica
Original Publication: New York.
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MeSH Terms:
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Embolization, Therapeutic/*adverse effects
Embolization, Therapeutic/*methods
Liver/*injuries
Patient Readmission/*statistics & numerical data
Adult ; Angiography ; Female ; Hepatic Artery ; Humans ; Liver/blood supply ; Liver/diagnostic imaging ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Wounds and Injuries/therapy ; Young Adult
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Contributed Indexing:
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Keywords: Angioembolization; Angiography; Hepatic injuries; Non-operative management
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Entry Date(s):
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Date Created: 20190706 Date Completed: 20200423 Latest Revision: 20200423
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Update Code:
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20240105
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DOI:
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10.1016/j.amjsurg.2019.06.021
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PMID:
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31272677
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Background: Indications for angioembolization (AE) following liver injury are not clearly defined. This study evaluated the outcomes and complications of hepatic AE. We hypothesize hepatic angioembolization is a useful adjunct to non-operative management of liver injury but with significant morbidity.
Methods: Subjects were identified utilizing trauma registries from centers in a regional trauma network from 2010 to 2017 with an Abbreviated Injury Scale (AIS) coded hepatic injury and an ICD9/10 for hepatic angiography (HA).
Results: 1319 patients with liver injuries were identified, with 30 (2.3%) patients undergoing HA: median ISS was 26, and median liver AIS was 4. Twenty-three subjects required AE. 81% had extravasation on CT from a liver injury. 63% underwent HA as initial intervention. 43% of AE subjects had liver-related complications with 35% 30-day readmission but with zero 30-day mortality.
Conclusions: While there were zero reported deaths, a high rate of morbidity and readmission was found. This may be due to the angioembolization or the liver injury itself.
(Copyright © 2019 Elsevier Inc. All rights reserved.)
