REBOA in patients with high-grade liver injury may be associated with worse outcomes

Wei Huang; Naveen Balan; Feifei Jin; Yu Cheng Chiu; Demetrios Demetriades

doi:10.1016/j.amjsurg.2024.116174

REBOA in patients with high-grade liver injury may be associated with worse outcomes

Am J Surg. 2024 Dec 31:241:116174. doi: 10.1016/j.amjsurg.2024.116174. Online ahead of print.

Authors

Wei Huang¹, Naveen Balan², Feifei Jin³, Yu Cheng Chiu⁴, Demetrios Demetriades⁵

Affiliations

¹ LA General Medical Center, University of Southern California, Los Angeles, CA, USA; Peking University People's Hospital, Trauma Center, Beijing, China. Electronic address: [email protected].
² LA General Medical Center, University of Southern California, Los Angeles, CA, USA. Electronic address: [email protected].
³ Peking University People's Hospital, Trauma Center, Beijing, China. Electronic address: [email protected].
⁴ LA General Medical Center, University of Southern California, Los Angeles, CA, USA; Department of General Surgery, Tri-Service General Hospital, Taiwan. Electronic address: [email protected].
⁵ LA General Medical Center, University of Southern California, Los Angeles, CA, USA. Electronic address: [email protected].

PMID: 39778330
DOI: 10.1016/j.amjsurg.2024.116174

Abstract

Background: Although controversial, resuscitative endovascular balloon occlusion of the aorta (REBOA) has been used to manage liver injuries. This matched cohort study evaluated outcomes in severe liver injuries treated with REBOA or without REBOA.

Methods: Trauma Quality Improvement Program database study. Patients with high-grade liver injuries (IV and V) treated with REBOA were propensity score matched (1:2) with similar patients managed without REBOA. Outcomes included mortality and complications.

Results: 252 patients treated with REBOA were matched with 503 patients managed without REBOA. Overall mortality was significantly higher in the REBOA group [57.9 % vs. 35.2 % (p < 0.001)]. The REBOA group patients had higher blood product transfusion requirements.

Conclusion: REBOA use in patients with high-grade liver injuries may be associated with poorer outcomes.

Keywords: Liver injury; Mortality; Outcome; REBOA.