A protocol for angiographic embolization in exsanguinating pelvic trauma: A report on 31 patients

Figures & data

Figure 1. Algorithm for the initial treatment of pelvic fractures in blunt high-energy trauma.

Table 1.  Additional injuries in the 31 patients

Lower extremity fracture	20
Cardiopulmonary injury	15
Cerebral injury	14
Upper extremity fracture	9
Abdominal injury	8
Vertebral body fracture	6
Major skin laceration	6
Lower urogenital injury	5
Facial fractures	5
Traumatic amputation of extremity	3
Injury to major extrapelvic vessel	2

Figure 2. CT-reconstruction of an unstable pelvic fracture with injury to the lateral sacral artery (arrow).

Table 2.  Distribution of arterial injuries as seen on angiography

	Number of patients
Internal iliac artery	28
Posterior trunk	3
Branches	25
Superior gluteal artery	11
Lateral sacral artery	4
Obturator artery	4
Internal pudendal artery	3
Iliolumbar artery	2
Umbilical artery	1
Lumbar artery	2
Superficial femoral artery	1

Table 3.  Characteristics of survivors and non–survivors. Values are median (range) if not otherwise stated

	All patients (n = 31)	Survivors (n = 26)	Non-survivors (n = 5)	Difference in means (95% CI)^a	P-value
Mean age at injury (years)	40 (9–82)	36 (9–82)	63 (39–79)	–45 to –9	0.004
Injury Severity Score	44 (9–66)	42 (9–66)	52 (43–66)	–23 to 3	0.1
Time from accident to	17admission (min) 0 (10–2,880)	220 (10–2,880)	85 (60–170)	–315 to 930	0.3
Time from admission	24to embolization (min)0 (40–11,400)	240 (40–3,600)	225 (80–600)	–1,385 to 2,862	0.5
Transfusions ^b/min	0.prior to embolization032 (0.002–0.1)	0.029 (0.002–0.085)	0.048 (0.017–0.10)	–0.04 to 0.007	0.1

^aIndependent Samples Test (equal variances assumed).

^bOne unit of packed red blood cells = 300 mL.