Purpose
This study aimed to evaluate the utilization and outcomes of resuscitative endovascular balloon occlusion of the aorta (REBOA) in managing noncompressible torso hemorrhage (NCTH) among trauma patients in Korea. The evolution of REBOA and its impact on patient survival was investigated as well as predictors of mortality.
Methods
This retrospective study included 234 post-REBOA patients from 5 leading regional trauma centers across Korea between 2016 and 2021. Primary outcomes were in-hospital mortality, and secondary outcomes were various clinical parameters regarding REBOA, overall treatment flow, and complications. For comparative analyses, patients were dichotomized into in-hospital non-survivors or survivors. Then, generalized additive and linear regression models were used to evaluate the trend of in-hospital mortality.
Results
The overall in-hospital mortality was 65.4%. The survivors had a higher proportion of responders following REBOA (87.7% vs 62.7%, p < 0.001). Key variables influencing outcomes included total occlusion time, red blood cell transfusion volume within the first 24 hours, revised trauma score, and systolic blood pressure gap. These factors significantly correlated with mortality rates in multivariate logistic regression.
Conclusion
Over 6 years, survival rates for NCTH patients undergoing REBOA in Korea have shown improvement. Despite diverse REBOA protocols across institutions, the results underscore the need for continued research, standardized practices, and national quality control measures to further optimize patient outcome and establish more effective treatment protocols for NCTH.

Purpose
Management options for extraperitoneal bladder injury (EBI) associated with pelvic fracture are variable. Predictive factors of operative management (OM) in patients with EBI associated pelvic fracture have not been previously addressed. This study assessed the current epidemiology of blunt traumatic urinary bladder injury and evaluated relevant clinical findings of patients with EBI associated with pelvic fracture who received OM.

Methods
Patients with urinary bladder injury with or without pelvic fracture from blunt trauma from January 1, 2014 to December 31, 2019 were identified from the institute trauma registry (n = 12,891). Demographics, mechanism of injury, type of urinary bladder injury, pelvic fracture configuration, and management options were analysed in the study population (n = 9,894).

Results
Of the 1,400 patients who had pelvic and/or acetabular fracture, 32 (2.3%) had urinary bladder injury. Of the 8,494 patients without pelvic and/or acetabular fracture, 12 (0.1%) had nonpelvic fracture urinary bladder injury. The total incidence of urinary bladder injuries in the study population was 0.4% (44/9,894). Patients with EBI associated with pelvic fracture who underwent OM, had a higher frequency of high-grade pelvic injury (100% vs 0%, p = 0.015), concomitant pelvic surgery (75.0% vs 0%, p = 0.001), and non-lateral compression type pelvic fracture (62.5% vs 10.0%, p = 0.043) compared with patients who underwent non-operative management of EBI.

Conclusions
These data suggest that OM may be considered especially in patients with EBI associated with pelvic fracture with high grade pelvic injury, concomitant pelvic surgery, and nonlateral compression type pelvic fracture.

Citations

• Delayed healing of extraperitoneal bladder rupture after open reduction for pelvic fracture: A case report
  Yu-Cheng Pei, Yeong-Chin Jou
  Tungs' Medical Journal.2025; 19(2): 131.     CrossRef

Purpose:

Patients with multiple traumas often experience multiple fractures that are missed or overlooked, despite the use of imaging, careful history taking, and physical examinations. This study aimed to evaluate the usefulness of whole body bone scan (WBBS) for detecting missed bone injuries in patients with multiple traumas.

Methods:

We evaluated 30 patients with multiple traumas who underwent WBBS at single tertiary referral center between March 2008 and February 2016. We assessed the association of patient demographics with WBBS uptake as a binomial outcome variable.

Results:

There were no significant differences in patient demographics by WBBS. The mean injury severity score did not differ by WBBS (18.1 in the WBBS-negative group vs. 18.4 in the WBBS-positive group), and duration from admission to the evaluation of the WBBS was similar (5.4 days in both groups). The most common uptake site in the WBBS was the ribs (n=7), followed by the tibia (n=3), skull (n=2), ankle (n=1), and sternum (n=1). None of the missed injuries required further treatment, such as manual reduction or surgery.

Conclusion:

WBBS was useful for detecting missed bone injuries in patients with multiple trauma.

Citations

• Analysis of Missed Skeletal Injuries Detected Using Whole-Body Bone Scan Applied to Trauma Patients: A Case–Control Study
  Jae Sik Chung, Sanghyun An, Seong Chan Gong, Pil Young Jung
  Diagnostics.2023; 13(11): 1879.     CrossRef