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Am J Surg. 2019 Sep 13. pii: S0002-9610(19)30349-6. doi: 10.1016/j.amjsurg.2019.09.007. [Epub ahead of print]

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is associated with improved survival in severely injured patients: A propensity score matching analysis.

Author information

1
Trauma Service/Department of Emergency and Critical Care Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan; Department of Surgery, UT Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA. Electronic address: ryo.yamamoto@gmail.com.
2
Department of Surgery, UT Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229-3900, USA.
3
Department of Emergency Medicine, Tokyo Dental College, Ichikawa General Hospital, 5-11-13 Sugano, Ichikawa, Chiba, 272-8513, Japan.
4
Department of Trauma and Emergency Surgery, Saiseikai Yokohamashi Tobu Hospital, 3-6-1 Shimosueyoshi, Tsurumiku, Yokohama, Kanagawa, 230-8765, Japan.
5
Trauma Service/Department of Emergency and Critical Care Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan.

Abstract

BACKGROUND:

Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a technique for temporary control of arterial hemorrhage. However, its effectiveness and clinical outcomes are unclear.

METHODS:

Using a nationwide database (2004-2016) in Japan, trauma patients with survival data were identified. Patients were divided between REBOA and non-REBOA groups, and a propensity score was developed using multivariate logistic regression. Survival to discharge was compared between the groups after propensity score matching.

RESULTS:

Among 82,371 patients included in this study, 385 were treated with REBOA. After propensity score matching, 117 pairs were selected. Survival to discharge was significantly higher among patients treated with REBOA than among those treated without REBOA (53 [45.3%] vs. 38 [32.5%]; odds ratio = 1.72; 95% CI = 1.01-2.93; p = 0.04).

CONCLUSIONS:

REBOA use was associated with improved survival to discharge and should therefore be considered during the management of severely injured trauma patients.

KEYWORDS:

Resuscitation; Resuscitative endovascular balloon occlusion of the aorta; Trauma

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