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Table 1 General characteristics

From: Resuscitative endovascular balloon occlusion of the aorta (REBOA) in patients with major trauma and uncontrolled haemorrhagic shock: a systematic review with meta-analysis

Study

Setting

Population

Intervention

Comparison

Outcome

Brenner 2018 [23]

Prospective observational

Resuscitation in Trauma and Acute

Care Surgery (AORTA) study was approved by the American Association for the Surgery

Adult trauma and acute care surgery (age ≥ 18) patients undergoing aortic occlusion (AO) in the acute phases after injury were enrolled

Blunt trauma was common (58.6% of which 83% REBOA group and 48.5% RT)

ISS: mean 38.2 (SD:18.9)

REBOA (n = 83)

Unclear modality of intervention (full/partial)*

RT (n = 202)

In-hospital mortality, complication, units packed red blood cells, units fresh frozen plasma, health-related quality of life (neurologic outcomes: Glasgow Coma Outcomes Score)

Aso 2017 [22]

Retrospective cohort study

Data from a national inpatient database in Japan

Trauma patients with uncontrolled haemorrhagic shock (n = 259); penetrating thoracic injuries were excluded

Blunt trauma (100%)

ISS: missing information

REBOA (n = 191)

Unclear modality of intervention (full/partial)

RT (n = 68)

In-hospital mortality, ventilator-free days (VFDs), intensive care unit (ICU)-free days, total amount of fluid infusion within 1 day after admission (mL), total amount of transfusion within 1 day after admission (mL), total hospitalization costs

Abe 2016 [21]

Retrospective cohort study

Japan Trauma Data Bank (JTDB) nationwide trauma registry

Trauma patients (n = 903)

Blunt trauma was common (838/895; 93.6%)

ISS: mean 34 (SD:25); mean 34 (SD:20)

REBOA (n = 636)

Unclear modality of intervention (full/partial)

Resuscitative open aortic cross-clamping (RT)

(n = 267)

In-hospital mortality, ED mortality, blood transfusion

DuBose 2016 [24]

Prospective observational

Multicentre data from Trauma and Acute Care Surgery registry (8 American College of Surgeons level I centres)

Adult trauma and acute care surgery (age ≥ 18) patients undergoing aortic occlusion (AO) in the acute phases after injury (n = 114)

Blunt trauma (62.3%)

ISS: median 31.0(IQR: 30); median 31.5 (IQR: 22)

REBOA (n = 46)

Unclear modality of intervention (full/partial)

AO (n = 68)

Haemodynamic stability, Improvement in haemodynamic red blood cell requirements, in-hospital mortality, ED mortality, Complications, health-related quality of life (neurologic outcomes: Glasgow Coma Outcomes Score)

Moore 2015 [29]

Retrospective cohort study

Trauma registry from two Level 1 trauma

Centres (Texas and Maryland-Baltimore)

Trauma patients in NCTH (n = 96)

Blunt trauma (44.4% RT; 66.7% REBOA)

ISS: median 34 (IQR:27–59); median 28 (IQR:17–43)

REBOA (n = 24)

Unclear modality of intervention (full/partial)

RT (n = 72)

In-hospital mortality, ED mortality

Matsumara 2017*

Retrospective cohort study

DIRECT-IABO Registry has been conducted by the Academic Committee in DIRECT in Japan

Trauma patients with refractory haemorrhagic shock

Blunt trauma (96%)

ISS: median 36 (IQR: 28–50); 44 (IQR: 38–59)

REBOA (n = 76)

Partial occlusion (70% of participants) *

RT + REBOA group

(n = 30)

In-hospital mortality

Nori 2015 [31]

Retrospective cohort study

Japan Trauma Data Bank

Critically uncontrolled haemorrhagic shock limited to blunt trauma patients.

Blunt trauma (100%)

ISS: mean 32.4 (SD:16.4)

REBOA (n = 351)

Unclear modality of intervention (full/partial)

Control group (n = 1456)

In-hospital mortality, health-related quality of life (neurologic outcomes: Glasgow Coma Outcomes Score)

García 2020 [25]

Retrospective cohort study

Clinical records at Fundación Valle del Lili University hospital in Cali, Colombia level-I trauma centre from Colombia

Patients with torso trauma who underwent surgical intervention for haemorrhage control excluded blunt trauma.

Penetrating trauma (100%)

ISS: median 25 (IQR: 16–25)

REBOA (n = 28)

Partial occlusion*

Control group (n = 317)

In-hospital mortality, PRBCs A in first 6 h , Plasma A in first 6 h, platelet A in first 6 h, Cryo A in first 6 h , Crystalloids in first 24 h, Thoracic damage control, Abdominal damage control, complications

Inoue 2016 [26]

Retrospective cohort study

Japan Trauma Data Bank

Patients with severe torso trauma

Blunt trauma (93.8%)

ISS: median 35 (IQR: 25–50); median 36 (IQR: 25–50)

REBOA (n = 625)

Unclear modality of intervention*

Control group (n = 625)

In-hospital mortality, ED mortality

Joseph 2019 [27]

Retrospective case-control study

ACSTQIP database and identified all patients who received REBOA within 1 h of admission

Trauma patients after REBOA placement

Blunt trauma (95%)

ISS: median 28 (IQR:17–35); median 29 (IQR: 18–38)

REBOA (n = 140)

Unclear modality of intervention*

Control group (n = 280)

In-hospital mortality, ED mortality, transfusion requirements at 4 h and 24 h after injury, in-hospital complications (deep venous thrombosis, pulmonary embolism, stroke, myocardial infarction, extremity compartment syndrome, health-related quality of life (neurologic outcomes: Glasgow Coma Outcomes Score)

Yamamoto 2019 [30]

Retrospective cohort study

Japan Trauma Data Bank

Severely injured patients

Blunt trauma (96% REBOA; 94% controls)

ISS: mean 35 (SD: 13); 33 (SD: 11)

REBOA (n = 117)

Control group (n = 117)

Survival at 28 days, a composite of in-hospital death, transfusion in number of patients

  1. Legend: AO open aortic occlusion, ACC resuscitative open aortic cross-clamping, BMI body mass index, JCS Japan Coma Scale, ED emergency department, NCTH non-compressible torso haemorrhage, RTS revised trauma score, RT resuscitative thoracotomy with aortic cross-clamping, TMPM-ICD9 the Trauma Mortality Prediction Model based on the ICD 9th Revision, TRISS Trauma and Injury Severity Score