Table 1. Characteristics of the Population Studied.
| Characteristic | Median (IQR) or No. (%) | P value | ||
|---|---|---|---|---|
| Total (n = 991 [100%]) | REBOA zone 1 (n = 306 [30.9%]) | Resuscitative thoracotomy (n = 685 [69.1%]) | ||
| Facility’s annual patient volume, No. (%) | ||||
| 1000-2000 | 202 (20.4) | 11 (3.6) | 191 (27.9) | <.001 |
| >2000-3000 | 188 (19.0) | 21 (6.9) | 167 (24.4) | |
| >3000 | 601 (60.6) | 274 (89.5) | 327 (47.7) | |
| Age, y | 32.0 (25.0 to 48.0) | 40.0 (27.0 to 57.0) | 30.0 (24.0 to 42.0) | <.001 |
| Sex | ||||
| Male | 808 (81.5) | 238 (77.8) | 570 (83.2) | .03 |
| Female | 183 (18.5) | 68 (22.2) | 115 (16.8) | |
| BMIa | 25.8 (23.5 to 30.5) | 26.0 (23.7 to 30.4) | 25.8 (23.2 to 30.6) | .67 |
| Injury characteristics, No. (%) | ||||
| Blunt mechanism | 565 (57.1) | 64 (21.1) | 501 (73.1) | <.001 |
| Injury Severity Score | 29.0 (18.0 to 50.0) | 33.0 (21.0 to 43.0) | 26.0 (17.0 to 50.0) | .73 |
| Head/neck AIS | 0 (0 to 2.0) | 1.0 (0 to 4.0) | 0 (0 to 0) | <.001 |
| Traumatic brain injury | 211 (21.3) | 118 (38.6) | 93 (13.6) | <.001 |
| Chest AIS | 3.0 (0 to 4.0) | 3.0 (0 to 4.0) | 3.0 (0 to 5.0) | .001 |
| Severe chest injury | 577 (58.2) | 174 (56.9) | 403 (58.8) | .56 |
| Abdomen AIS | 0 (0 to 3.0) | 2.0 (0 to 4.0) | 0 (0 to 2.0) | <.001 |
| Severe abdomen injury | 315 (31.8) | 149 (48.7) | 166 (24.2) | <.001 |
| Pelvic AIS | 0 | 0 | 0 | .97 |
| Severe pelvic injury | 14 (1.4) | 5 (1.6) | 9 (1.3) | .69 |
| Extremity AIS | 0 | 0 (0 to 0) | 0 (0 to 0) | <.001 |
| Severe extremity injury | 56 (5.7) | 8 (2.6) | 48 (7.0) | .01 |
| Prehospital | ||||
| SBP, mm Hg | 76.0 (0 to 111.5) | 96.0 (62.0 to 129.0) | 40.0 (0 to 92.0) | <.001 |
| Heart rate, beats/min | 86.0 (22.0 to 120.0) | 100.0 (69.0 to 128.0) | 68.0 (0 to 110.0) | <.001 |
| Shock index | 0.8 (0 to 1.4) | 0.9 (0.6 to 1.3) | 0.8 (0 to 1.5) | .06 |
| GCS | 3.0 (3.0 to 10.0) | 3.0 (3.0 to 12.0) | 3.0 (3.0 to 8.0) | <.001 |
| CPR, No. (%) | 443 (45.4) | 97 (31.8) | 346 (51.6) | <.001 |
| Minutes from injury to hospital | 30.0 (20.0 to 53.0) | 43.0 (28.0 to 65.0) | 24.0 (16.0 to 40.0) | <.001 |
| Hospital admission | ||||
| SBP, mm Hg | 0 (0 to 83.5) | 77.0 (0 to 107.0) | 0 (0 to 56.0) | <.001 |
| Heart rate, beats/min | 0 (0 to 106.0) | 99.0 (24.0 to 129.0) | 0 (0 to 69.5) | <.001 |
| Shock index | 0 (0 to 1.2) | 1.0 (0.2 to 1.6) | 0 (0 to 0.7) | <.001 |
| GCS | 3.0 (3.0 to 3.0) | 3.0 (3.0 to 7.0) | 3.0 (3.0 to 3.0) | <.001 |
| CPR, No. (%) | 449 (45.4) | 94 (30.7) | 355 (51.9) | <.001 |
| CPR duration, No. (%) | ||||
| 60 min or more | 16 (1.7) | 6 (2.0) | 10 (1.5) | <.001 |
| <60 min | 387 (41.0) | 79 (26.6) | 308 (47.6) | |
| Not applicable | 541 (57.3) | 212 (71.4) | 329 (50.9) | |
| Laboratory tests | ||||
| Hemoglobin, g/dL | 11.0 (9.2 to 12.5) | 11.0 (9.4 to 12.3) | 11.0 (8.9 to 12.6) | .82 |
| Prothrombin INR | 1.6 (1.3 to 2.2) | 1.6 (1.2 to 2.0) | 1.7 (1.3 to 2.4) | .04 |
| Base excess, mEq/L | −14.0 (−20.0 to −8.0) | −11.5 (−16.0 to −8.0) | −16.0 (−23.0 to −9.5) | <.001 |
| Lactate, mmol/L | 9.3 (6.0 to 14.3) | 8.3 (4.9 to 12.1) | 11.3 (7.2 to 15.2) | <.001 |
| AO characteristics, No. (%) | ||||
| CPR during AO | 507 (51.7) | 114 (37.5) | 393 (58.1) | <.001 |
| AO initial SBP, mm Hg | 0 (0 to 40.0) | 53.0 (0 to 70.0) | 0 | <.001 |
| AO initial SBP ≤60 mm Hg | 154 (17.3) | 116 (41.0) | 38 (6.3) | <.001 |
| AO initial GCS | 3.0 (3.0 to 3.0) | 3.0 (3.0 to 3.0) | 3.0 (3.0 to 3.0) | <.001 |
| AO performer = trauma surgeon | 706 (72.5) | 239 (81.3) | 467 (68.7) | <.001 |
| Hemodynamic improvement | 440 (45.1) | 220 (72.6) | 220 (32.7) | <.001 |
| Hemodynamic stabilityb | 256 (26.4) | 108 (16.1) | 148 (49.2) | <.001 |
| SBP after first AO, mm Hg | 0 (0 to 107.0) | 105.0 (71.5 to 126.0) | 0 (0 to 51.5) | <.001 |
| GCS after first AO | 3.0 (3.0 to 3.0) | 3.0 (3.0 to 3.0) | 3.0 (3.0 to 3.0) | <.001 |
| First AO duration, min | 20.0 (9.0 to 48.0) | 30.0 (12.0 to 70.0) | 15.0 (8.0 to 36.0) | <.001 |
| Second AO needed | 51 (6.0) | 17 (6.0) | 34 (6.1) | .99 |
| Second AO type | ||||
| Endovascular | 28 (54.9) | 9 (52.9) | 19 (55.9) | .84 |
| Open | 23 (45.1) | 8 (47.1) | 15 (44.1) | |
| Minutes to start first AO | 5.0 (2.0 to 13.0) | 14.0 (7.0 to 23.0) | 3.0 (2.0 to 7.0) | <.001 |
| Minutes to first successful AO | 11.0 (6.0 to 20.0) | 20.0 (13.0 to 31.0) | 7.0 (5.0 to 12.0) | <.001 |
| Transfusions, fluids, inotropes, and TXA in first 24 h | ||||
| Red blood cell units | 6.0 (3.0 to 17.0) | 12.0 (4.0 to 26.0) | 5.0 (2.0 to 12.0) | <.001 |
| Plasma units | 4.0 (2.0 to 13.0) | 8.0 (3.0 to 21.0) | 3.0 (1.0 to 8.0) | <.001 |
| Platelets units | 1.0 (0 to 3.0) | 2.0 (0 to 5.0) | 0 (0 to 3.0) | <.001 |
| Cryoprecipitate units | 0 (0) | 0 (0 to 1.0) | 0 (0 to 0.0) | .001 |
| TXA, No. (%) | 221 (28.5) | 93 (34.3) | 128 (25.4) | .01 |
| Complications and outcomes, No. (%) | ||||
| Acute kidney injury | 70 (7.1) | 48 (15.7) | 22 (3.2) | <.001 |
| Acute lung injury | 50 (5.0) | 24 (7.8) | 26 (3.8) | .01 |
| Multiple organ failure | 28 (2.8) | 18 (5.9) | 10 (1.5) | <.001 |
| Pneumonia | 40 (4.0) | 22 (7.2) | 18 (2.6) | <.001 |
| Sepsis | 37 (3.7) | 31 (10.1) | 6 (0.9) | <.001 |
| Stroke | 7 (0.7) | 3 (1.0) | 4 (0.6) | .49 |
| Spinal ischemia with neurodeficit | 3 (0.3) | 2 (0.7) | 1 (0.1) | .18 |
| Vascular reconstruction | 27 (8.8) | 27 (10.1) | 0 | .03 |
| Extremity ischemia | 11 (1.1) | 10 (3.3) | 1 (0.1) | <.001 |
| Amputation | 4 (0.4) | 4 (1.3) | 0 | .01 |
| Ventilation days | 1.0 (0 to 1.0) | 1.0 (1.0 to 4.0) | 1.0 (0 to 1.0) | <.001 |
| VFD | 0 (0) | 0 (0 to 0.5) | 0 (0 to 0.0) | <.001 |
| VFD >0 | 100 (10.2) | 76 (25.0) | 24 (3.5) | <.001 |
| ICU days | 0 (0 to 1.0) | 1.0 (0 to 5.0) | 0 (0) | <.001 |
| ICU-free days | 0 (0 to 0.0) | 0 (0 to 0.0) | 0 (0) | <.001 |
| ICU-free days >0 | 99 (10.0) | 74 (24.3) | 25 (3.7) | <.001 |
| Discharge GCS (survivors only) | 15.0 (15.0 to 15.0) | 15.0 (15.0 to 15.0) | 15.0 (15.0 to 15.0) | .16 |
| Discharge GCS = 15 (survivors only) | 87 (84.5) | 68 (87.2) | 19 (76.0) | .18 |
| Discharge GOS | 1.0 (1.0 to 1.0) | 1.0 (1.0 to 1.0) | 1.0 (1.0 to 1.0) | <.001 |
| Discharge GOS ≥5 | 29 (3.1) | 22 (8.3) | 7 (1.0) | <.001 |
| Discharge disposition | ||||
| Home | 55 (5.5) | 36 (11.8) | 19 (2.8) | <.001 |
| Mortality | 869 (87.7) | 218 (71.2) | 651 (95.0) | |
| Rehabilitation/nursing facility | 67 (6.8) | 52 (17.0) | 15 (2.2) | |
| Death | 870 (87.8) | 218 (71.2) | 652 (95.2) | <.001 |
| Death location | ||||
| ED | 504 (57.9) | 83 (38.1) | 421 (64.6) | <.001 |
| ICU | 161 (18.5) | 86 (39.4) | 75 (11.5) | |
| Interventional radiology | 3 (0.3) | 2 (0.9) | 1 (0.2) | |
| Operating room | 201 (23.1) | 47 (21.6) | 154 (23.6) | |
Abbreviations: AIS, abbreviated injury score; AO, aortic occlusion; AORTA, Aortic Occlusion for Resuscitation in Trauma and Acute Care Surgery; BMI, body mass index; CPR, cardiopulmonary resuscitation; ED, emergency department; GCS, Glasgow Coma Scale; GOS, Glasgow Outcome Score; ICU, intensive care unit; INR, international normalized ratio; SBP, systolic blood pressure; TXA, tranexamic acid; VFD, ventilation-free days.
SI conversion factor: To convert hemoglobin from gram per deciliter to gram per liter, multiply by 10; to convert base excess from milliequivalent per liter to millimole per liter, multiply by 1; to convert lactate from millimole per liter to milligram per deciliter, divide by 0.111.
a
Calculated as weight in kilograms divided by height in meters squared.
b
Defined for the purposes of the AORTA registry systolic blood pressure consistently greater than 90 mm Hg for at least 5 minutes after AO.