Hemostatic Interventions and All-Cause Mortality in Hemodynamically Unstable Pelvic Fractures: A Systematic Review and Meta-Analysis.

IF 1.2 4区 医学 Q3 EMERGENCY MEDICINE
Emergency Medicine International Pub Date : 2024-08-26 eCollection Date: 2024-01-01 DOI:10.1155/2024/6397444
XuWen Zheng, MaoBing Chen, Yi Zhuang, Jin Xu, Liang Zhao, YongJun Qian, WenMing Shen, Ying Chu
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引用次数: 0

Abstract

Objective: To conduct a systematic review and meta-analysis of the all-cause mortality associated with the most commonly used hemostatic treatments in patients with hemodynamically unstable pelvic fractures.

Methods: Up to April 30, 2023, we searched PubMed, Embase, Web of Science, and Cochrane, including the references to qualified papers. A meta-analysis was performed on studies that reported odds ratios (ORs) or the number of events needed to calculate them. The PROSPERO registration number was CRD42023421137.

Results: Of the 3452 titles identified in our original search, 29 met our criteria. Extraperitoneal packing (EPP) (OR = 0.626 and 95% CI = 0.413-0.949), external fixation (EF) (OR = 0.649 and 95% CI = 0.518-0.814), and arterial embolism (AE) (OR = 0.459 and 95% CI = 0.291-0.724) were associated with decreased mortality. Resuscitative endovascular balloon occlusion of the aorta (REBOA) (OR = 2.824 and 95% CI = 1.594-5.005) was associated with increased mortality. A random effect model meta-analysis of eight articles showed no difference in mortality between patients with AE and patients with EPP for the initial treatments for controlling blood loss (OR = 0.910 and 95% CI = 0.623-1.328).

Conclusion: This meta-analysis collectively suggested EF, AE, or EPP as life-saving procedures for patients with hemodynamically unstable pelvic fractures.

止血干预与血流动力学不稳定骨盆骨折的全因死亡率:系统综述与元分析》。
目的对血流动力学不稳定骨盆骨折患者最常用的止血治疗方法相关的全因死亡率进行系统回顾和荟萃分析:截至 2023 年 4 月 30 日,我们检索了 PubMed、Embase、Web of Science 和 Cochrane,包括合格论文的参考文献。对报告了几率比(OR)或计算几率比所需的事件数的研究进行了荟萃分析。PROSPERO注册号为CRD42023421137:结果:在我们最初搜索到的 3452 篇论文中,有 29 篇符合我们的标准。腹膜外填塞(EPP)(OR = 0.626,95% CI = 0.413-0.949)、外固定(EF)(OR = 0.649,95% CI = 0.518-0.814)和动脉栓塞(AE)(OR = 0.459,95% CI = 0.291-0.724)与死亡率降低相关。主动脉血管内球囊闭塞复苏术(REBOA)(OR = 2.824,95% CI = 1.594-5.005)与死亡率增加有关。对 8 篇文章进行的随机效应模型荟萃分析显示,在控制失血的初始治疗中,AE 患者与 EPP 患者的死亡率没有差异(OR = 0.910,95% CI = 0.623-1.328):这项荟萃分析共同建议将 EF、AE 或 EPP 作为血流动力学不稳定骨盆骨折患者的救命手术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Emergency Medicine International
Emergency Medicine International EMERGENCY MEDICINE-
CiteScore
0.10
自引率
0.00%
发文量
187
审稿时长
17 weeks
期刊介绍: Emergency Medicine International is a peer-reviewed, Open Access journal that provides a forum for doctors, nurses, paramedics and ambulance staff. The journal publishes original research articles, review articles, and clinical studies related to prehospital care, disaster preparedness and response, acute medical and paediatric emergencies, critical care, sports medicine, wound care, and toxicology.
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