Limited Resources at a Community Based Level 1 Trauma Center: Does This Affect Pelvic Angioembolization Times During Daylight Hours versus after Hours, Weekends, and Holidays?

Abstract

Hemodynamically unstable patients with pelvic fractures require swift intervention due to the high mortality of their injuries. A delay in embolization of these patients significantly affects survival. We therefore, hypothesized that there would be a significant difference between time to embolization at our larger rural Level 1 Trauma Center. This study investigated the relationship between interventional radiology (IR) order time to IR procedure start time over 2 time periods at our large, rural Level 1 Trauma Center with those having sustained a traumatic pelvic fracture requiring IR, and having been identified as being in shock. The current study found no statistically significant difference from time from order to IR start between the 2 cohorts (Mann–Whitney U test, P = .902). The results suggest we are delivering a consistent standard of care at our institution for pelvic trauma, based on IR order time to start of the procedure.

Transcatheter Arterial Embolization for Bleeding Related to Pelvic Trauma: Comparison of Technical and Clinical Results between Hemodynamically Stable and Unstable Patients

“…Currently, the World Society of Emergency Surgery management guidelines for pelvic trauma reserve a pivotal role for transcatheter arterial embolization (TAE) in both hemodynamically stable and unstable patients, especially if the surgical option is not deemed appropriate [5]. Of note, a dedicated interventional radiology team is required on standby or on call, with around-the-clock access to a catheterization lab [15][16][17].…”