Angioembolization Has Similar Efficacy and Lower Total Charges than Preperitoneal Pelvic Packing in Patients with Pelvic Ring or Acetabulum Fractures

Abstract

OBJECTIVES: To compare cost, hospital related outcomes, and mortality between angioembolization (AE) and preperitoneal pelvic packing (PPP) in the setting of pelvic ring or acetabulum fractures. METHODS: Design: Retrospective database review. Setting: The National Inpatient Sample, years 2016-2020. Patient Selection Criteria: Hospitalized adult patients who underwent AE or PPP in the setting of a pelvic ring or acetabulum fracture. Outcome Measures and Comparisons: Mortality, and hospital associated outcomes, including total charges following AE versus PPP in the setting of pelvic ring or acetabulum fractures. RESULTS: A total of 3,780 patients, 3,620 undergoing angioembolization and 160 undergoing PPP were included. No significant differences in mortality, LOS, time to procedure, or discharge disposition were found (p>0.05); however, PPP was associated with significantly greater charges than angioembolization (p=0.04). Patients who underwent angioembolization had a mean total charge of $250,062.88, while those undergoing PPP had a mean of total charge of $369,137.16. CONCLUSIONS: Despite equivalent clinical efficacy in terms of mortality and hospital related outcomes, preperitoneal pelvic packing was associated with significantly greater charges than angioembolization in the setting of pelvic ring or acetabulum fractures. This data information can inform clinical management of these patients and assist trauma centers in resource allocation. LEVEL OF EVIDENCE: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.