Aim: Substantial variations in the utilization of angioembolization have been reported internationally. However, the existence of variations in the utilization of angioembolization in Japan is currently unknown.
Methods: This was a cross-sectional study using data from a nationwide trauma registry in Japan. Of the 4,896 registered adult patients with splenic injury, we investigated 3,319 patients in the top 25% of the hospitals that registered the highest number of splenic injury patients in the Japan Trauma Data Bank. The primary outcome of this study was initial angioembolization. We calculated the expected initial angioembolization rates using multiple regression analysis adjusted for patient factors. In addition, we evaluated the range of observed-to-expected initial splenic angioembolization ratio for each hospital. Moreover, we assessed whether this ratio was increased with time.
Results: The frequency of initial splenic angioembolization ranged from 0% to 52%. The median expected initial angioembolization rate, calculated through multiple logistic regression analysis, was 19.7%. The observed-to-expected initial splenic angioembolization ratio for each hospital ranged from 0 to 2.36. The observed initial angioembolization rate tended to increase with time ( < 0.001).
Conclusions: Despite adjustment for patient factors, substantial variations were observed in the utilization of splenic angioembolization among hospitals in Japan.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10097635 | PMC |
| http://dx.doi.org/10.1002/ams2.837 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Pelvic packing - status 2024.
Arch Orthop Trauma Surg
January 2025
Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway.
Patients with unstable hemodynamics and unstable pelvic ring injuries are still demanding patients regarding initial treatment and survival. Several concepts were reported during the last 30 years. Mechanical stabilization of the pelvis together with hemorrhage control offer the best treatment option in these patients.
View Article and Find Full Text PDFEvolution of management strategies for unstable pelvic ring injuries over the past 40 years: a systematic review.
Patient Saf Surg
December 2024
Department of Trauma Surgery, University Hospital Zurich, University of Zurich, Raemistr. 100, Zurich, 8091, Switzerland.
Background: Hemodynamically unstable pelvic ring fractures from high-energy trauma are critical injuries in trauma care, requiring urgent intervention and precise diagnostics. With ongoing advancements in trauma management, treatment strategies have evolved, with some techniques becoming obsolete as new ones emerge. This study aimed to evaluate changes and trends in treatment algorithms for these injuries over approximately 40 years.
View Article and Find Full Text PDFFollow-up strategy for early detection of delayed pseudoaneurysms in patients with blunt traumatic spleen injury: A single-center retrospective study.
World J Gastrointest Surg
October 2024
Department of Surgery, Trauma Center, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu 41944, South Korea.
Background: The spleen is the most commonly injured solid organ in blunt abdominal trauma, and splenic pseudoaneurysm rupture is associated with a high risk of mortality. Nonoperative management has become the standard treatment for hemodynamically stable patients with splenic injuries. On the other hand, delayed splenic pseudoaneurysms can develop in any patient, and at present, there are no known risk factors that may reliably predict their occurrence.
View Article and Find Full Text PDFA comparison of adult and pediatric guidelines for the management of blunt splenic trauma.
Asian J Surg
November 2024
Department of Traumatology, John Hunter Hospital, Newcastle, New South Wales, Australia. Electronic address:
Article Synopsis
- The management of blunt splenic trauma differs between children and adults, influenced by guidelines from organizations like the APSA and WTA, particularly regarding treatment methods like splenectomy and angioembolization.* -
- A comparison of the 2023 guidelines revealed that while initial resuscitation is standard, the management strategies diverge: adults' care is guided by both CT findings and hemodynamic status, while children's care relies solely on hemodynamics.* -
- Differences in ICU admission, follow-up protocols, and thromoprophylaxis use highlight the distinct approaches for each age group, suggesting a need for unified guidelines that cater to the specific needs of both children and adults.*
Surgical excision of recurrent renal angiomyolipoma after previous embolization and nephron-sparing surgery - A case report.
Int J Surg Case Rep
November 2024
Department of Medical Imaging and Radiology, Nepal Mediciti Hospital, Nepal.
Introduction: Renal angiomyolipoma is the most common benign kidney tumor, representing 1-3 % of solid renal tumors. Despite its benign nature, it can be associated with lethal hemorrhage, and can also show signs of local extension mimicking malignant tumors. The cornerstone of treatment remains angioembolization and nephron sparing surgery.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!