Abstract
Introduction
Pelvic fractures result in hemodynamic instability in 5% to 20% of patients, and the
reported mortality rate is 18% to 40%. Previous studies have reported the application
of angioembolization in pelvic fracture patients with a systolic blood pressure (SBP)
less than 90 mm Hg, a fluid resuscitation requirement of more than 2000 mL, or a blood
transfusion of more than 4 to 6 units within 24 hours. In the current study, we attempted
to delineate the efficacy and outcome of angioembolization in unstable pelvic fracture
patients with concomitant unstable hypotension status.
Methods
We retrospectively reviewed the charts of patients with pelvic fractures between January
2005 and May 2010. We focused on unstable pelvic fracture patients with an SBP less
than 90 mm Hg after fluid resuscitation who did not receive computed tomography scans.
The demographics, injury severity score, abbreviated injury scale, and hemodynamic
status after angioembolization were analyzed.
Results
In total, 26 patients were enrolled. There were 16 patients receiving angioembolization
directly without computed tomography scans and 12 patients receiving emergency laparotomy
due to a finding of hemoperitoneum on sonography, followed by angioembolization. In
both groups, the SBP improved significantly after angioembolization. The overall survival
rate was 85.7%.
Conclusions
In patients with concomitant unstable hemodynamics and unstable pelvic fracture, angioembolization
serves as an effective adjunct to hemostasis. Aggressive embolization should be performed
even in patients without contrast extravasation in angiography.
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Article Info
Publication History
Published online: December 15, 2010
Accepted:
November 5,
2010
Received in revised form:
November 5,
2010
Received:
October 6,
2010
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
