(1541) The Hybrid Emergency Room System Impacts on Survival After Angioembolization for Pelvic Fracture

Introduction: It is well known that timely angioembolization (AE) improves outcomes of patients with hemorrhage due to pelvic fracture. Hybrid Emergency Room System (HERS) is a trauma resuscitation room which equipped with a computed tomography scanner, fluoroscopy, and operating room set-up. We hypothesized that the HERS improves the outcomes of patients who undergo AE for pelvic fracture.

Methods: A retrospective medical record review was performed for patients who underwent AE for pelvic fracture at our institution (4/2015–6/2023). Patients’ demographics, the location of AE, the probability of survival by the trauma and injury severity score (TRISS) method (TRISS Ps), the presence of IRs upon patient arrival, the time from arrival to AE, and the in-hospital mortality rate were analyzed. These data were compared between patients who underwent AE in the regular angio-suite (Non-HERS group) and in the HERS (HERS group).

Results: In total, 166 patients met the inclusion criteria. The Non-HERS group comprised 88 patients, and the HERS group comprised 78 patients. Compared with the Non-HERS group, the HERS group had a higher incidence of simultaneous or subsequent surgery (35.9 vs 13.6%, p=0.001), and performance of resuscitative endovascular balloon occlusion of the aorta (16.9 vs 9.1%, p=0.134). IRs were more frequently present upon patient arrival in the HERS than Non-HERS group (88.5% vs 27.1%, p< 0.001). The mean time from arrival to AE was shorter in the HERS than Non-HERS group (50±36 minutes vs 159±139 minutes, p< 0.001). There were no differences in the rate of in-hospital mortality between the two groups (15.4% vs 13.6%, p=0.749). The TRISS Ps was lower in the HERS than Non-HERS group (53.8±34.4% vs 78.0±27.1%, p< 0.001). The unexpected survivor rate was higher in the HERS than Non-HERS group (32.3% vs 5.6%, p< 0.001).

Conclusions: The HERS improved the timeliness of AE and the unexpected survivor rate among patients with pelvic fracture. Simultaneous or subsequent surgery was performed along with AE in the HERS. The addition of IRs to the traditional trauma resuscitation team seemed to enhance the benefit of the HERS. Further study is warranted to establish a standardized protocol for care of trauma patients in the HERS.