PMID- 36590045
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20240102
IS  - 0970-9134 (Print)
IS  - 0973-7723 (Electronic)
IS  - 0970-9134 (Linking)
VI  - 39
IP  - 1
DP  - 2023 Jan
TI  - A comparison of mortality and indicators of treatment success of resuscitative 
      endovascular balloon occlusion of aorta (REBOA): a systematic review and 
      meta-analysis.
PG  - 27-36
LID - 10.1007/s12055-022-01413-3 [doi]
AB  - BACKGROUND: Emergency resuscitative thoracotomy (RT) is a recognised method of 
      controlling non-compressible torso haemorrhage (NCTH) often in adjunct to 
      emergency surgery. Recently, there is much debate regarding resuscitative 
      endovascular balloon occlusion of aorta (REBOA) on its role in civilian trauma 
      cases in controlling NCTH. This study aims to provide an updated review on 
      in-hospital mortality rates in patients who underwent REBOA versus RT and 
      standard care without REBOA (non-REBOA) and to identify the potential indicators 
      of REBOA survival. METHODS: Cochrane and Preferred Reporting Items for Systematic 
      Reviews and Meta-Analysis (PRISMA) guidelines were used to perform the study. All 
      adult trauma cases were included, while pre-hospital, military and non-English 
      studies were excluded. A literature search was done on studies from 01 January 
      2005 to 30 June 2020 using EMBASE, MEDLINE and COCHRANE databases. Risk of bias 
      was assessed using the Methodological Index for Non-Randomised Studies (MINORS) 
      tool. Meta-analysis was conducted using a random effects model and the 
      DerSimonian and Laird estimation method. A significance level of p < 0.05 was 
      used. RESULTS: Twenty-five studies were included in this study. The odds of 
      in-hospital mortality of patients who underwent REBOA compared to RT was 0.18 
      (p < 0.01, 0.12-0.26). The odds of in-hospital survival of patients who underwent 
      REBOA compared to non-REBOA was 1.28 (p = 0.62, 0.46-3.53). There was a 
      significant difference found between survivors and non-survivors in terms of 
      their pre-REBOA systolic blood pressure (SBP) (19.26 mmHg, p < 0.01), post-REBOA 
      SBP (20.73 mmHg, p < 0.01), duration of aortic occlusion (- 40.57 min, p < 0.01) 
      and injury severity score (- 8.50, p < 0.01). CONCLUSIONS: REBOA has a potential 
      for wider application in civilian settings, with our study demonstrating lower 
      in-hospital mortality compared to RT. Prospective multi-centre studies are needed 
      for further evaluation of the indications and feasibility of REBOA.Level of 
      Evidence + Study Type: Level IV. Systematic review with meta-analysis. 
      SUPPLEMENTARY INFORMATION: The online version contains supplementary material 
      available at 10.1007/s12055-022-01413-3.
CI  - (c) Crown 2022.
FAU - Ko, Ho Juen
AU  - Ko HJ
AUID- ORCID: 0000-0001-7843-8991
AD  - University College London, London, UK. GRID: grid.83440.3b. ISNI: 
      0000000121901201
AD  - Department of HPB & Liver Transplantation, Division of Surgery & Interventional 
      Sciences, Royal Free Hospital, Pond Street, Hampstead, NW2 2QG London UK. GRID: 
      grid.426108.9. ISNI: 0000 0004 0417 012X
FAU - Koo, Hui Fen
AU  - Koo HF
AD  - University College London, London, UK. GRID: grid.83440.3b. ISNI: 
      0000000121901201
FAU - Al-Saadi, Nina
AU  - Al-Saadi N
AD  - Vascular Surgery Glenfield Hospital UHL NHS Trust, Leicester, UK. GRID: 
      grid.412925.9. ISNI: 0000 0004 0400 6581
FAU - Froghi, Saied
AU  - Froghi S
AD  - University College London, London, UK. GRID: grid.83440.3b. ISNI: 
      0000000121901201
LA  - eng
PT  - Journal Article
DEP - 20221109
PL  - India
TA  - Indian J Thorac Cardiovasc Surg
JT  - Indian journal of thoracic and cardiovascular surgery
JID - 8700105
PMC - PMC9794671
OTO - NOTNLM
OT  - Aortic occlusion
OT  - Haemorrhage
OT  - Mortality
OT  - REBOA
OT  - Resuscitative Thoracotomy
COIS- Conflict of interestThe authors have no conflicts of interest.
EDAT- 2023/01/03 06:00
MHDA- 2023/01/03 06:01
PMCR- 2024/01/01
CRDT- 2023/01/02 04:14
PHST- 2022/05/19 00:00 [received]
PHST- 2022/07/04 00:00 [revised]
PHST- 2022/07/12 00:00 [accepted]
PHST- 2023/01/02 04:14 [entrez]
PHST- 2023/01/03 06:00 [pubmed]
PHST- 2023/01/03 06:01 [medline]
PHST- 2024/01/01 00:00 [pmc-release]
AID - 1413 [pii]
AID - 10.1007/s12055-022-01413-3 [doi]
PST - ppublish
SO  - Indian J Thorac Cardiovasc Surg. 2023 Jan;39(1):27-36. doi: 
      10.1007/s12055-022-01413-3. Epub 2022 Nov 9.