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Trauma-Angio score as a predictor of urgent angioembolization for blunt trauma: development and validation using independent cohorts

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Abstract

Purpose

This research aimed to establish a scoring system for selecting candidates for urgent angioembolization (AE).

Methods

Patients with blunt trauma were retrospectively identified in a nationwide trauma registry. Patients aged ≥ 15 years with a systolic blood pressure of ≥90 mmHg were included. These individuals were then categorized into development and validation cohorts based on the date of admission. Next, an eight-point scaled system was developed using odds ratios obtained from the multivariate analysis of patients’ clinical factors on their arrival at the hospital, with the implementation of urgent AE as a dependent variable.

Results

The development cohort and validation cohort included 158,192 and 116,941 patients, respectively, and 3296 (2.1%) patients in the development cohort and 2,550 (2.2%) patients in the validation cohort underwent urgent AE. The frequency of transfusion within 24 h after arrival and the Injury Severity Score were similar between the two cohorts (16,867 [10.7%] vs. 11,222 [9.6%] and 10 [9–18] vs. 10 [9–17], respectively). The number of patients who were discharged and hospital-free days were comparable between the two cohorts (139,436 [94.4%] vs. 106,107 [95.6%] and 72 [53–84] vs. 73 [57–84] days, respectively). The probabilities and the observed rates of urgent AE increased proportionally from 2% at a score of ≤ 3 to almost 15% at a score of ≥ 7. In terms of predictive factors, no significant interaction was noted.

Conclusion

The Trauma-Angio scoring system can be used as a trigger to suggest the possibility of urgent AE.

Trial Registration

20090087, 31st July 2009.

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Authors and Affiliations

  1. Department of Emergency and Critical Care Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan

    Katsuya Maeshima, Ryo Yamamoto & Junichi Sasaki

Authors
  1. Katsuya Maeshima
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  2. Ryo Yamamoto
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  3. Junichi Sasaki
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Correspondence to Katsuya Maeshima.

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The authors declare no conflicts of interest and received no financial support for the preparation of this article for publication.

Ethics approval

This study was approved by the local institutional review board for the Conduct of Human Research of all collaborating hospitals. It was approved by the ethics committee of Keio University of Medicine (approval number: 20090087). The need for informed consent was waived because anonymized data were used.

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Maeshima, K., Yamamoto, R. & Sasaki, J. Trauma-Angio score as a predictor of urgent angioembolization for blunt trauma: development and validation using independent cohorts. Eur J Trauma Emerg Surg 48, 4837–4845 (2022). https://doi.org/10.1007/s00068-022-02008-8

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