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Emergency Hemorrhage Control Strategies and Outcomes in Hemodynamically Unstable Pelvic Fracture Trauma: A Systematic Review | ||
| Bulletin of Emergency And Trauma | ||
| مقالات آماده انتشار، پذیرفته شده، انتشار آنلاین از تاریخ 18 آبان 1404 اصل مقاله (910.17 K) | ||
| نوع مقاله: Review Article | ||
| شناسه دیجیتال (DOI): 10.30476/beat.2025.107327.1614 | ||
| نویسندگان | ||
| Elnaz Olama1؛ Omid Nikoo2؛ Salma Dehbozorgi3؛ Elham Hassannia4؛ Zahra Jafarzadeh Jahromi5؛ Amin Azad6؛ Majid Salamati* 7 | ||
| 1Faculty of Medicine, Georgian National University SEU, Tbilisi 0166, Georgia. | ||
| 2Faculty of medicine, shiraz university of medical sciences, shiraz, iran | ||
| 3Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran | ||
| 4faculty of medicine, kerman university of medical sciences, Kerman, Iran | ||
| 5Faculty of medicine, Jahrom university of medical sciences, Jahrom, Iran | ||
| 6Department of Orthopedics, Babol University of Medical Sciences, Babol, Iran | ||
| 7Department of Surgery, School of Medicine, Emam Khomeini Hospital, Ilam University of Medical Sciences, Ilam, Iran | ||
| چکیده | ||
| Objectives: This systematic review aimed to evaluate and compare emergency hemorrhage control interventions for hemodynamically unstable pelvic fracture trauma, assessing clinical outcomes, including mortality, transfusion requirements, and complication rates. Methods: A comprehensive literature search of PubMed, Scopus, Web of Science, and Google Scholar was conducted in December 2024. Studies were selected based on predefined inclusion criteria, which considered adult patients (≥18 years) with hemodynamically unstable pelvic fractures. Data extraction and quality assessment were performed using standardized tools. Interventions of interest included preperitoneal pelvic packing (PPP), angioembolization (AE), resuscitative endovascular balloon occlusion of the aorta (REBOA), and mechanical stabilization. Results: Ten studies were included. PPP and AE demonstrated comparable in-hospital mortality rates. However, PPP was associated with shorter intervention times and reduced early transfusion requirements. Mechanical stabilization was universally recommended as an initial step, while REBOA served as a temporizing measure. The overall strength of evidence was moderate, derived primarily from retrospective studies and meta-analyses, with no randomized controlled trials identified. Conclusion: Both PP and AE were effective for hemorrhage control in hemodynamically unstable pelvic fractures, with the choice of first-line intervention often dependent on logistical factors. The development of standardized protocols and prospective studies should be prioritized in future work to optimize management strategies. | ||
| کلیدواژه‌ها | ||
| Pelvic fracture؛ Hemorrhage control؛ Preperitoneal packing؛ Angioembolization | ||
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