Prognostic factors for treatment outcome of angioembolization in patients with liver or spleen injury

Abstract

The spleen and liver are the two most commonly injured abdominal organs following trauma. With increasing advances and experience in interventional radiology, many cases of splenic or liver injuries are treated by angioembolization (AE). The purpose of this study was to investigate of the prognostic factors associated with failure of AE treatment and major impact on mortality in patients with liver or spleen injury.We retrospectively identified patients who were diagnosed with traumatic liver or spleen injury and completed of AE treatment at the Wonju Severance Christian Hospital from May 1, 2003 to December 31, 2012. Treatment failure of AE was defined as if necessary of surgery after procedure. The significant prognostic factors associated with outcome of AE treatment were analyzed.Ninety nine patients were eligible for analysis. Eight patients (8.9%) experienced of treatment failure. As might easily expect, significantly more amount of transfusion after procedure was needed as a result from failure of treatment (11.0 vs. 4.0 U, p=0.009). But, other factors were not associated with treatment failure of AE. Also failure of AE treatment was not significant association with mortality. The significant prognostic factors that have major impact on mortality were 1.0≤ SI (OR=44.22, 95% CI=1.96-997.93) and increased amount of post-embolization PRBC transfusion (OR=1.24, 95% CI=1.07-1.43) on multivariate analysis.In conclusion, only significantly prognostic factor for treatment failure of AE was amount of PRBC transfusion after procedure. Failure of AE was not significant association with mortality. We found that elevated initial SI (1.0≤) and large amount of PRBC transfusion were an independent factor for poor survival rate in liver and spleen injury patient.