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Efficacy of extra-peritoneal pelvic packing in hemodynamically unstable pelvic fractures, a Propensity Score Analysis

Overview of attention for article published in World Journal of Emergency Surgery, June 2016
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Title
Efficacy of extra-peritoneal pelvic packing in hemodynamically unstable pelvic fractures, a Propensity Score Analysis
Published in
World Journal of Emergency Surgery, June 2016
DOI 10.1186/s13017-016-0077-2
Pubmed ID
Authors

Osvaldo Chiara, Emanuele di Fratta, Anna Mariani, Bertuzzi Michaela, Lucia Prestini, Fabrizio Sammartano, Stefania Cimbanassi

Abstract

An option for emergency control of pelvic hemorrhage is Extra-peritoneal Pelvic Packing (EPP), which addresses the retroperitoneal source of exsanguination in pelvic fractures. The aim of this study was to demonstrate the efficacy of early EPP in reducing mortality due to hemorrhage from pelvic fractures, and to evaluate the impact of packing on transfusion requirements within the first 24 h and ICU length of stay (ICU-LOS). All data pertaining trauma patients admitted from October 2002 and December 2103 with hemodynamic instability and pelvic fractures were selected from the Hospital Trauma Registry. Patients with severe brain injury and bleeding from extra-pelvic sources were excluded. Patient population was divided into two groups: EPP group, including patients admitted from 2009 to 2013, with EPP as part of the treatment algorithm, and NO-EPP group, from 2002 to 2008, without EPP as atherapeutic option. Descriptive statistical analysis was performed on allpatients. Twenty-five patients of each group with similar features were matched using Propensity Score Analysis (PSA). Six hundred eighty out of 4659 major trauma (14.6 %) presented a pelvic fracture. In 78 hemodynamically unstable patients (30 in EPP group,48 in NO-EPP group) the major source of bleeding was the pelvis. Among patients selected by PSA early mortality was significantly reduced in EPP group (20 vs 52 %, p = .03) compared to NO-EPP, notwithstanding similar hemodynamic impairment. No difference was observed in transfusion requirements and ICU-LOS. The EPP is a safe and quick procedure, able to improve hemodynamic stabilization and to reduce acute mortality due to hemorrhage in patients with pelvic fracture, in combination with optimized transfusion protocol. EPP may be useful as a bridge for time-consuming procedures, such as angio-embolization.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 50 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Japan 1 2%
Unknown 49 98%

Demographic breakdown

Readers by professional status Count As %
Researcher 9 18%
Professor > Associate Professor 6 12%
Student > Doctoral Student 5 10%
Other 5 10%
Student > Master 5 10%
Other 9 18%
Unknown 11 22%
Readers by discipline Count As %
Medicine and Dentistry 32 64%
Nursing and Health Professions 1 2%
Sports and Recreations 1 2%
Psychology 1 2%
Social Sciences 1 2%
Other 1 2%
Unknown 13 26%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 02 June 2016.
All research outputs
#15,376,252
of 22,875,477 outputs
Outputs from World Journal of Emergency Surgery
#310
of 547 outputs
Outputs of similar age
#211,610
of 339,120 outputs
Outputs of similar age from World Journal of Emergency Surgery
#13
of 19 outputs
Altmetric has tracked 22,875,477 research outputs across all sources so far. This one is in the 22nd percentile – i.e., 22% of other outputs scored the same or lower than it.
So far Altmetric has tracked 547 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.3. This one is in the 33rd percentile – i.e., 33% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 339,120 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 29th percentile – i.e., 29% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 19 others from the same source and published within six weeks on either side of this one. This one is in the 21st percentile – i.e., 21% of its contemporaries scored the same or lower than it.