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<p>This retrospective observational study compared the outcomes of transcatheter arterial embolization (TAE) versus open surgery in patients with blunt abdominal solid organ injury (liver, spleen, or kidney; abdominal Abbreviated Injury Scale [AIS] ≥ 3) with traumatic brain injury (TBI) (head AIS ≥ 3), using data from the Japan Trauma Data Bank (2004–2019). Patient characteristics were adjusted using propensity score matching. The primary endpoint was in-hospital mortality; secondary endpoints included 48-h mortality, transfusion requirements, and complications. After matching, 135 patients per group were analyzed. In-hospital mortality was significantly lower in the TAE group (25/135 [18.5%] vs. 42/135 [31.1%], adjusted odds ratio [AOR] 0.247, 95% confidence interval 0.101–0.605, <i>p</i> = 0.002). TAE also showed lower 48-h mortality (10/135 [7.4%] vs. 22/135 [16.3%], AOR 0.306, <i>p</i> = 0.008) and transfusion rates. Complication rates were similar. Subgroup analysis showed that TAE was associated with lower mortality in non-shock (AOR 0.392, <i>p</i> = 0.032), elderly (AOR 0.293, <i>p</i> = 0.044), and focal TBI patients (AOR 0.301, <i>p</i> = 0.004) but not in patients with diffuse TBI. TAE may be a feasible treatment option for selected patients with blunt abdominal solid organ injury complicated by TBI, particularly in hemodynamically stable, elderly, and focal TBI patients. These findings require prospective validation.</p>

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Comparative outcomes of transcatheter arterial embolization versus open surgery for blunt abdominal solid organ injury with concurrent traumatic brain injury

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月29日

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  • Tensei Suzuki,
  • Mitsuaki Kojima,
  • Atsushi Shiraishi,
  • Koji Morishita

摘要

This retrospective observational study compared the outcomes of transcatheter arterial embolization (TAE) versus open surgery in patients with blunt abdominal solid organ injury (liver, spleen, or kidney; abdominal Abbreviated Injury Scale [AIS] ≥ 3) with traumatic brain injury (TBI) (head AIS ≥ 3), using data from the Japan Trauma Data Bank (2004–2019). Patient characteristics were adjusted using propensity score matching. The primary endpoint was in-hospital mortality; secondary endpoints included 48-h mortality, transfusion requirements, and complications. After matching, 135 patients per group were analyzed. In-hospital mortality was significantly lower in the TAE group (25/135 [18.5%] vs. 42/135 [31.1%], adjusted odds ratio [AOR] 0.247, 95% confidence interval 0.101–0.605, p = 0.002). TAE also showed lower 48-h mortality (10/135 [7.4%] vs. 22/135 [16.3%], AOR 0.306, p = 0.008) and transfusion rates. Complication rates were similar. Subgroup analysis showed that TAE was associated with lower mortality in non-shock (AOR 0.392, p = 0.032), elderly (AOR 0.293, p = 0.044), and focal TBI patients (AOR 0.301, p = 0.004) but not in patients with diffuse TBI. TAE may be a feasible treatment option for selected patients with blunt abdominal solid organ injury complicated by TBI, particularly in hemodynamically stable, elderly, and focal TBI patients. These findings require prospective validation.