Survival benefits of interventional radiology and surgical teams collaboration during primary trauma surveys: a single-centre retrospective cohort study

Author:

Okada Ichiro1,Hifumi Toru2,Yoneyama Hisashi3,Inoue Kazushige3,Seki Satoshi3,Jimbo Ippei4,Takada Hiroaki3,Nagasawa Koichi3,Kohara Saiko3,Hishikawa Tsuyoshi3,Shiojima Hiroki3,Hasegawa Eiju3,Morimoto Kohei5,Ichinose Yoshiaki3,Sato Fumie3,Kiriu Nobuaki6,Matsumoto Junichi7,Yokobori Shoji1

Affiliation:

1. Nippon Medical School Hospital

2. St. Luke’s International Hospital

3. National Hospital Organization Disaster Medical Center

4. Kyorin University Hospital

5. Kawasaki Municipal Tama Hospital

6. National Defense Medical College

7. St Marianna University School of Medicine

Abstract

Abstract Background A team approach is essential for effective trauma management. Close collaboration between interventional radiologists and surgeons during the initial management of trauma patients is important for prompt and accurate trauma care. This study aimed to determine whether trauma patients benefit from close collaboration between interventional radiology (IR) and surgical teams during the primary trauma survey. Methods A retrospective observational study was conducted between 2014 and 2021 at a single institution. Patients were assigned to an embolization group (EG), a surgery group (SG), or a combination group (CG) according to their treatment. The primary and secondary outcomes were survival at hospital discharge compared with the probability of survival (Ps) and the time course of treatment. Results The analysis included 197 patients, consisting of 135 men and 62 women, with a median age of 56 [IQR, 38–72] years and an injury severity score of 20 [10–29]. The EG, SG, and CG included 114, 48, and 35 patients, respectively. Differences in organ injury patterns were observed between the three groups. In-hospital survival rates in all three groups were higher than Ps. In particular, survival in the CG was 15.5% higher than the Ps (95% CI: 7.5–23.6%; p < 0.001). In the CG, the median time for starting the initial procedure was 53 [37–79] min and the procedure times for IR and surgery were 48 [29–72] min and 63 [13–48] min, respectively. Those times were significantly shorter between three groups. Conclusion Close collaboration between IR and surgical teams, including the primary survey, improves the survival of severe trauma patients who require both IR procedures and surgeries by improving appropriate treatment selection and reducing the time process.

Publisher

Research Square Platform LLC

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