Hospital mortality of blunt abdominal aortic injury (BAAI): a systematic review and meta-analysis

Abstract

Abstract Background Studies on the mortality of blunt abdominal aortic injury (BAAI) are rare, and the rates reported by them vary widely. We aimed to quantitatively analyze the data retrieved and reveal the hospital mortality of this disease more precisely. Methods Published studies were searched on Excerpta Medica Database (Embase), PubMed, Web of Science (WOS) and Cochrane Library without date restriction. We set the overall hospital mortality (OHM) and its 95% confidence interval (CI) of BAAI patients as the primary outcome measure. English references with data that met the selection criteria were included. The quality of all included studies was assessed by the Joanna Briggs Institute (JBI) checklist and the American Agency for Health Care Quality and Research’s (AHQR) cross-sectional study quality evaluation items. After data extraction, a meta-analysis was performed using the metaprop command of joint the Freeman-Tukey double arcsine transformation of data in Stata 16 software. Heterogeneity was assessed and reported as a percentage using the I² index value and as a P value using the Cochrane Q test. And various methods were used to find out the source of heterogeneity and analyze the sensitivity of the computation model. Results Of 2,147 references screened, 5 studies that involve 1,593 patients were included because of meeting the selection criteria. There were no low-quality references after assessment. There was 1 study that only included 16 juvenile BAAI patients was excluded from the meta-analysis of the primary outcome measure due to great heterogeneity. Because of low heterogeneity (I2 = 47.6%, P = 0.126 for Q test) after analysis using a random effects model, pooling the ESs of remaining four references using a fixed effects model yielded an OHM = 28.8% (95% CI, 26.5%-31.1%). The good stability of the model was verified by checking calculation. Egger’s test yielded P = 0.339, which shows the low publication bias of the model. In addition, we also performed meta-analyses and obtained the pooled hospital mortality of operation [13.5% (95%CI, 8.0%-20.0%)] and the pooled hospital mortality of non-operation [28.4% (95%CI, 25.9%-31.0%)] of BAAI, respectively. Conclusions BAAI has an OHM of 28.8%. This serious disease deserves more attention and research.