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A meta-analysis of ...
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.
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- Manzano-Nunez, Ramiro (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, Colombia
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- Orlas, Claudia P. (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, Colombia
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- Herrera-Escobar, Juan P. (author)
- 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, Samuel (author)
- R Adams Cowley Shock Trauma Center, Baltimore MD, USA
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- DuBose, Joseph (author)
- R Adams Cowley Shock Trauma Center, Baltimore MD, USA
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- Melendez, Juan J. (author)
- Trauma and Acute Care Surgery Fellowship, Department of Surgery, Universidad del Valle, Cali, Colombia
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- Serna, Jose J. (author)
- Trauma and Acute Care Surgery Fellowship, Department of Surgery, Universidad del Valle, Cali, Colombia
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- Salcedo, Alexander (author)
- Trauma and Acute Care Surgery Fellowship, Department of Surgery, Universidad del Valle, Cali, Colombia
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- Peña, Camilo A. (author)
- Trauma and Acute Care Surgery Fellowship, Department of Surgery, Universidad del Valle, Cali, Colombia
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- Angamarca, Edison (author)
- Trauma and Acute Care Surgery Fellowship, Department of Surgery, Universidad del Valle, Cali, Colombia
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- Hörer, Tal M., 1971- (author)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län
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- Salazar, Camilo J. (author)
- School of Medicine, ICESI University, Cali, Colombia
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- Lopez-Castilla, Valeria (author)
- School of Medicine, ICESI University, Cali, Colombia
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- Ruiz-Yucuma, Juan (author)
- School of Medicine, ICESI University, Cali, Colombia
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- Rodriguez, Fernando (author)
- Division of Trauma and Acute Care Surgery, Department of Surgery, Fundacion Valle del Lili, Cali, Colombia
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- Parra, Michael W. (author)
- Department of Trauma Critical Care, Broward General Level I Trauma Center. Fort Lauderdale FL, USA
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- Ordoñez, Carlos A. (author)
- 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
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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, Colombia Center for Surgery and Public Health, Department of Surgery, Brigham & Women's Hospital, Harvard Medical School & Harvard TH. Chan School of Public Health. Boston MA, USA (creator_code:org_t)
- Lippincott Williams & Wilkins, 2018
- 2018
- English.
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In: Journal of Trauma and Acute Care Surgery. - : Lippincott Williams & Wilkins. - 2163-0755 .- 2163-0763. ; 85:3, s. 626-634
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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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
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Keyword
- Wounds and injuries
- REBOA
- endovascular procedures
- intraoperative complications
- benchmarking
Publication and Content Type
- ref (subject category)
- for (subject category)
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- By the author/editor
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Manzano-Nunez, R ...
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Orlas, Claudia P ...
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Herrera-Escobar, ...
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Galvagno, Samuel
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DuBose, Joseph
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Melendez, Juan J ...
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show more...
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Serna, Jose J.
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Salcedo, Alexand ...
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Peña, Camilo A.
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Angamarca, Ediso ...
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Hörer, Tal M., 1 ...
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Salazar, Camilo ...
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Lopez-Castilla, ...
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Ruiz-Yucuma, Jua ...
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Rodriguez, Ferna ...
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Parra, Michael W ...
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Ordoñez, Carlos ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Surgery
- Articles in the publication
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Journal of Traum ...
- By the university
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Örebro University