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A meta-analysis of ...
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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 ...
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Lippincott Williams & Wilkins,2018
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printrdacarrier
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LIBRIS-ID:oai:DiVA.org:oru-67103
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https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-67103URI
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https://doi.org/10.1097/TA.0000000000001978DOI
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:for swepub-publicationtype
Notes
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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
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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
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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
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Galvagno, SamuelR Adams Cowley Shock Trauma Center, Baltimore MD, USA
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DuBose, JosephR Adams Cowley Shock Trauma Center, Baltimore MD, USA
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Melendez, Juan J.Trauma and Acute Care Surgery Fellowship, Department of Surgery, Universidad del Valle, Cali, Colombia
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Serna, Jose J.Trauma and Acute Care Surgery Fellowship, Department of Surgery, Universidad del Valle, Cali, Colombia
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Salcedo, AlexanderTrauma and Acute Care Surgery Fellowship, Department of Surgery, Universidad del Valle, Cali, Colombia
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Peña, Camilo A.Trauma and Acute Care Surgery Fellowship, Department of Surgery, Universidad del Valle, Cali, Colombia
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Angamarca, EdisonTrauma and Acute Care Surgery Fellowship, Department of Surgery, Universidad del Valle, Cali, Colombia
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Hörer, Tal M.,1971-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län(Swepub:oru)thr
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Salazar, Camilo J.School of Medicine, ICESI University, Cali, Colombia
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Lopez-Castilla, ValeriaSchool of Medicine, ICESI University, Cali, Colombia
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Ruiz-Yucuma, JuanSchool of Medicine, ICESI University, Cali, Colombia
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Rodriguez, FernandoDivision of Trauma and Acute Care Surgery, Department of Surgery, Fundacion Valle del Lili, Cali, Colombia
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Parra, Michael W.Department of Trauma Critical Care, Broward General Level I Trauma Center. Fort Lauderdale FL, USA
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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)
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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)
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In:Journal of Trauma and Acute Care Surgery: Lippincott Williams & Wilkins85:3, s. 626-6342163-07552163-0763
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Serna, Jose J.
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Örebro University