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An Early Experience of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in the Republic of Korea: A Retrospective Multicenter Study

Journal of Trauma and Injury 2020년 33권 3호 p.144 ~ 152
박준현, 장성우, 유병철, 이길재, 장성욱, 김동헌, 장예림, 정필영,
소속 상세정보
박준현 ( Park Joon-Hyeon ) - Yonsei University Wonju Severance Christian Hospital Department of Surgery
장성우 ( Jang Sung-Woo ) - Yonsei University Wonju Severance Christian Hospital Department of Surgery
유병철 ( Yu Byung-Chul ) - Gachon University Gil Medical Center Department of Surgery
이길재 ( Lee Gil-Jae ) - Gachon University Gil Medical Center Department of Surgery
장성욱 ( Chang Sung-Wook ) - Dankook University Hospital Department of Thoracic and Cardiovasular Surgery
김동헌 ( Kim Dong-Hun ) - Dankook University Hospital Department of Surgery
장예림 ( Chang Ye-Rim ) - Dankook University Hospital Department of Surgery
정필영 ( Jung Pil-Young ) - Yonsei University Wonju Severance Christian Hospital Department of Surgery

Abstract


Purpose: This retrospective multicenter study analyzed trauma patients who underwent resuscitative endovascular balloon occlusion of the aorta (REBOA) in the Republic of Korea.

Methods: This study was conducted from February 2017 to May 2018 at three regional trauma centers in the Republic of Korea. The patients were divided into two groups (cardiopulmonary resuscitation [CPR] and No-CPR) for comparative analysis based on two criteria (complication and mortality) for logistic regression analysis (LRA).

Results: There were significant differences between the CPR and No-CPR groups in mortality (p=0.003) and treatment administered (p=0.016). By LRA for complications, total occlusion has significantly lesser risk than intermittent or partial occlusion in both univariate (odds ratio [OR] 0.06, 95% confidence interval [CI] 0.00-0.36, p=0.01) and multivariate (OR 0.05, 95% CI 0.00-0.38, p=0.01) analyses. The Rescue had a higher risk than the Coda or Reliant in univariate analysis (OR 4.91, 95% CI 1.14-34.25, p=0.05); however, it was not statistically significant in multivariate analysis (OR 6.98, 95% CI 1.03-74.52, p=0.07). By LRA for mortality, the CPR group was the only variable that had a significantly higher risk of mortality than the No-CPR group in both univariate (OR 17.59, 95% CI 3.05-335.25, p=0.01), and multivariate (OR 24.92, 95% CI 3.77-520.51, p=0.01) analyses.

Conclusions: This study was conducted in the early stages of REBOA implementation in the Republic of Korea and showed conflicting results from studies conducted by multiple institutions. Therefore, additional research with more accumulated data is needed.

키워드

Balloon occlusion; Aorta; Republic of Korea; Trauma centers

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