Table 2:
Hemorrhage control procedures and resuscitation parameters before and after implementation of a dedicated, trauma hybrid operating room (OR).
| Hemorrhage control and resuscitation | Control cases (n=106) | Hybrid OR cases (n=186) | p |
|---|---|---|---|
| Transferred from ED directly to OR | 59 (56%) | 119 (64%) | 0.172 |
| Underwent REBOA | 1 (1%) | 18 (8%) | 0.013 |
| Underwent sternotomy or thoracotomy | 7 (7%) | 24 (13%) | 0.115 |
| Aortic cross clamp placed | 4 (4%) | 13 (7%) | 0.309 |
| Pericardiotomy | 5 (5%) | 19 (10%) | 0.123 |
| Cardiac laceration repair | 1 (1%) | 6 (3%) | 0.428 |
| Pulmonary resection or tractotomy | 1 (1%) | 3 (2%) | >0.999 |
| Underwent laparotomy | 81 (76%) | 144 (77%) | 0.885 |
| Solid organ resection | 29 (27%) | 47 (25%) | 0.782 |
| Solid organ repair | 15 (14%) | 40 (22%) | 0.161 |
| Hollow viscous resection | 25 (24%) | 30 (16%) | 0.123 |
| Diaphragm repair | 10 (9%) | 16 (9%) | 0.833 |
| Underwent preperitoneal pelvic packing | 9 (8%) | 23 (12%) | 0.338 |
| Underwent neck exploration | 9 (8%) | 13 (7%) | 0.650 |
| Operative management of a named vessel | 28 (26%) | 58 (31%) | 0.425 |
| Bypass, interposition graft, or patch repair | 7 (7%) | 11 (6%) | 0.805 |
| Endovascular stent or balloon angioplasty | 2 (2%) | 2 (1%) | 0.623 |
| Primary repair | 5 (5%) | 20 (11%) | 0.085 |
| Ligation | 15 (14%) | 22 (12%) | 0.586 |
| CT or Vascular Surgery consultation | 14 (13%) | 23 (12%) | 0.856 |
| Underwent angiography | 19 (18%) | 39 (21%) | 0.647 |
| Angiography performed in IR suite | 16 (15%) | 0 (0%) | <0.001 |
| Central/aortogram | 5 (5%) | 8 (4%) | >0.999 |
| Peripheral/extremity angiography | 3 (3%) | 5 (3%) | >0.999 |
| Visceral angiography | 6 (6%) | 9 (5%) | 0.787 |
| Pelvic angiography | 7 (7%) | 22 (12%) | 0.221 |
| Therapeutic angiographya | 13 (12%) | 24 (13%) | >0.999 |
| Obtained hemorrhage controlb | 102 (96%) | 176 (95%) | 0.777 |
| Interval: OR start to hemorrhage control (min) | 60 [42–84] | 49 [34–69] | 0.005 |
| Total OR plus angiography time (min) | 133 [92–243] | 135 [91–188] | 0.971 |
| TXA administered 0–4 h after arrival | 20 (19%) | 33 (18%) | 0.875 |
| RBC transfusions 0–4 h after arrival | 3.0 [0.0–5.0] | 2.5 [1.0–5.0] | 0.730 |
| Plasma transfusions 0–4 h after arrival | 2.0 [0.0–4.0] | 1.5 [0.0–4.0] | 0.742 |
| RBC transfusions 4–24 h after arrival | 1.0 [0.0–3.0] | 0.0 [0.0–2.0] | 0.001 |
| Plasma transfusions 4–24 h after arrival | 1.0 [0.0–3.0] | 0.0 [0.0–1.0] | <0.001 |
a
Endovascular stent placement, balloon angioplasty, coil placement, or embolization.
b
Systolic blood pressure 100 mmHg or greater without ongoing vasopressor or blood product transfusion requirements. ED: emergency department, REBOA: resuscitative endovascular balloon occlusion of the aorta, CT: presented as n (%) or median [interquartile range]. Cardiothoracic, IR: Interventional Radiology, TXA: tranexamic acid, RBC: red blood cell. Data are presented as n (%) or median [interquartile range].