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  • Manzano-Nunez, RamiroClinical Research Center, Fundacion Valle del Lili, Cali, Colombia; Division of Trauma and Acute Care Surgery, Department of Surgery, Fundacion Valle del Lili, Cali, Colombia (author)

A meta-analysis of the incidence of complications associated with groin access after the use of resuscitative endovascular balloon occlusion of the aorta in trauma patients.

  • Article/chapterEnglish2018

Publisher, publication year, extent ...

  • Lippincott Williams & Wilkins,2018
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:oru-67103
  • https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-67103URI
  • https://doi.org/10.1097/TA.0000000000001978DOI

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  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:for swepub-publicationtype

Notes

  • BACKGROUND: Serious complications related to groin access have been reported with the use of resuscitative endovascular balloon occlusion of the aorta (REBOA). We performed a systematic review and meta-analysis to estimate the incidence of complications related to groin access from the use of REBOA in adult trauma patients.METHODS: We identified articles in MEDLINE and EMBASE. We reviewed all studies that involved adult trauma patients that underwent the placement of a REBOA and included only those that reported the incidence of complications related to groin access. A meta-analysis of proportions was performed RESULTS: We 13 studies with a total of 424 patients. REBOA was inserted most commonly by trauma surgeons or emergency room physicians. Information regarding puncture technique was reported in 12 studies and was available for a total of 414 patients. Percutaneous access and surgical cutdown were performed in 304 (73.4%) and 110 (26.5%) patients respectively. Overall, complications related to groin access occurred in 5.6% of patients (n=24/424). Lower limb amputation was required in 2.1% of patients (9/424), of which three cases (3/424 [0.7%]) were directly related to the vascular puncture from the REBOA insertion. A meta-analysis which used the logit transformation showed a 5% (95% CI 3%-9%) incidence of complications without significant heterogeneity (LR test: χ2 = 0.73, p=0.2, Tau-square=0.2). In a second meta-analysis, we used the Freeman-Turkey double arcsine transformation and found an incidence of complications of 4% (95% CI 2%-7%) with low heterogeneity (I2 = 16.3%).CONCLUSION: We found that the incidence of complications related to groin access was of four to five percent based on a meta-analysis of 13 studies published worldwide. Currently, there are no benchmarks or quality measures as a reference to compare, and thus, further work is required to identify these benchmarks and improve the practice of REBOA in trauma surgery.LEVEL OF EVIDENCE: Systematic Review and Meta-analysis, Level III.

Subject headings and genre

Added entries (persons, corporate bodies, meetings, titles ...)

  • Orlas, Claudia P.Clinical Research Center, Fundacion Valle del Lili, Cali, Colombia; Division of Trauma and Acute Care Surgery, Department of Surgery, Fundacion Valle del Lili, Cali, Colombia (author)
  • Herrera-Escobar, Juan P.Center for Surgery and Public Health, Department of Surgery, Brigham & Women's Hospital, Harvard Medical School & Harvard T.H. Chan School of Public Health. Boston MA, USA (author)
  • Galvagno, SamuelR Adams Cowley Shock Trauma Center, Baltimore MD, USA (author)
  • DuBose, JosephR Adams Cowley Shock Trauma Center, Baltimore MD, USA (author)
  • Melendez, Juan J.Trauma and Acute Care Surgery Fellowship, Department of Surgery, Universidad del Valle, Cali, Colombia (author)
  • Serna, Jose J.Trauma and Acute Care Surgery Fellowship, Department of Surgery, Universidad del Valle, Cali, Colombia (author)
  • Salcedo, AlexanderTrauma and Acute Care Surgery Fellowship, Department of Surgery, Universidad del Valle, Cali, Colombia (author)
  • Peña, Camilo A.Trauma and Acute Care Surgery Fellowship, Department of Surgery, Universidad del Valle, Cali, Colombia (author)
  • Angamarca, EdisonTrauma and Acute Care Surgery Fellowship, Department of Surgery, Universidad del Valle, Cali, Colombia (author)
  • Hörer, Tal M.,1971-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län(Swepub:oru)thr (author)
  • Salazar, Camilo J.School of Medicine, ICESI University, Cali, Colombia (author)
  • Lopez-Castilla, ValeriaSchool of Medicine, ICESI University, Cali, Colombia (author)
  • Ruiz-Yucuma, JuanSchool of Medicine, ICESI University, Cali, Colombia (author)
  • Rodriguez, FernandoDivision of Trauma and Acute Care Surgery, Department of Surgery, Fundacion Valle del Lili, Cali, Colombia (author)
  • Parra, Michael W.Department of Trauma Critical Care, Broward General Level I Trauma Center. Fort Lauderdale FL, USA (author)
  • Ordoñez, Carlos A.Division of Trauma and Acute Care Surgery, Department of Surgery, Fundacion Valle del Lili, Cali, Colombia; Trauma and Acute Care Surgery Fellowship, Department of Surgery, Universidad del Valle, Cali, Colombia (author)
  • Clinical Research Center, Fundacion Valle del Lili, Cali, Colombia; Division of Trauma and Acute Care Surgery, Department of Surgery, Fundacion Valle del Lili, Cali, ColombiaCenter for Surgery and Public Health, Department of Surgery, Brigham & Women's Hospital, Harvard Medical School & Harvard T.H. Chan School of Public Health. Boston MA, USA (creator_code:org_t)

Related titles

  • In:Journal of Trauma and Acute Care Surgery: Lippincott Williams & Wilkins85:3, s. 626-6342163-07552163-0763

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