Role of pelvic packing in the first attention given to hemodynamically unstable pelvic fracture patients: a meta-analysis
Abstract Purpose To evaluate the effectiveness of pelvic packing (PP) in pelvic fracture patients with hemodynamic instability. Materials and methods Three databases—PubMed, Embase and the Cochrane Library—were systematically searched to identify studies presenting comparisons between a protocol inc...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2022-07-01
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| Series: | Journal of Orthopaedics and Traumatology |
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| Online Access: | https://doi.org/10.1186/s10195-022-00647-6 |
| _version_ | 1811324356955996160 |
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| author | Pengyu Li Fanxiao Liu Qinghu Li Dongsheng Zhou Jinlei Dong Dawei Wang |
| author_facet | Pengyu Li Fanxiao Liu Qinghu Li Dongsheng Zhou Jinlei Dong Dawei Wang |
| author_sort | Pengyu Li |
| collection | DOAJ |
| description | Abstract Purpose To evaluate the effectiveness of pelvic packing (PP) in pelvic fracture patients with hemodynamic instability. Materials and methods Three databases—PubMed, Embase and the Cochrane Library—were systematically searched to identify studies presenting comparisons between a protocol including PP and a protocol without PP. Mortality, transfusion requirement and length of hospitalization were extracted and pooled for meta-analysis. Relative risk (RR) and standard mean difference (SMD), along with their confidence intervals (CIs), were used as the pooled statistical indices. Results Eight studies involving 480 patients were identified as being eligible for meta-analysis. PP usage was associated with significantly reduced overall mortality (RR = 0.61, 95% CI = 0.47–0.79, p < 0.01) as well as reduced mortality within 24 h after admission (RR = 0.42, 95% CI = 0.26–0.69, p < 0.01) and due to hemorrhage (RR = 0.26, 95% CI = 0.14–0.50, p < 0.01). The usage of PP also decreased the need for pre-operative transfusion (SMD = − 0.44, 95% CI = − 0.69 to − 0.18, p < 0.01), but had no influence on total transfusion during the first 24 h after admission (SMD = 0.05, 95% CI = − 0.43–0.54, p = 0.83) and length of hospitalization (ICU stay and total stay). Conclusions This meta-analysis indicates that a treatment protocol including PP could reduce mortality and transfusion requirement before intervention in pelvic fracture patients with hemodynamic instability vs. angiography and embolization. This latter technique could be used as a feasible and complementary technique afterwards. Level of evidence 3. |
| first_indexed | 2024-04-13T14:12:48Z |
| format | Article |
| id | doaj.art-220ab40d06b7418ca5511a5846b9be24 |
| institution | Directory Open Access Journal |
| issn | 1590-9921 1590-9999 |
| language | English |
| last_indexed | 2024-04-13T14:12:48Z |
| publishDate | 2022-07-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Journal of Orthopaedics and Traumatology |
| spelling | doaj.art-220ab40d06b7418ca5511a5846b9be242022-12-22T02:43:44ZengSpringerOpenJournal of Orthopaedics and Traumatology1590-99211590-99992022-07-0123111110.1186/s10195-022-00647-6Role of pelvic packing in the first attention given to hemodynamically unstable pelvic fracture patients: a meta-analysisPengyu Li0Fanxiao Liu1Qinghu Li2Dongsheng Zhou3Jinlei Dong4Dawei Wang5Department of Interventional Radiology and Vascular Surgery, Peking University First HospitalDepartment of Orthopedic, Shandong Provincial Hospital, Affiliated to Shandong First Medical UniversityDepartment of Orthopedic, Shandong Provincial Hospital, Affiliated to Shandong First Medical UniversityDepartment of Orthopedic, Shandong Provincial Hospital, Affiliated to Shandong First Medical UniversityDepartment of Orthopedic, Shandong Provincial Hospital, Affiliated to Shandong First Medical UniversityDepartment of Orthopedic, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong UniversityAbstract Purpose To evaluate the effectiveness of pelvic packing (PP) in pelvic fracture patients with hemodynamic instability. Materials and methods Three databases—PubMed, Embase and the Cochrane Library—were systematically searched to identify studies presenting comparisons between a protocol including PP and a protocol without PP. Mortality, transfusion requirement and length of hospitalization were extracted and pooled for meta-analysis. Relative risk (RR) and standard mean difference (SMD), along with their confidence intervals (CIs), were used as the pooled statistical indices. Results Eight studies involving 480 patients were identified as being eligible for meta-analysis. PP usage was associated with significantly reduced overall mortality (RR = 0.61, 95% CI = 0.47–0.79, p < 0.01) as well as reduced mortality within 24 h after admission (RR = 0.42, 95% CI = 0.26–0.69, p < 0.01) and due to hemorrhage (RR = 0.26, 95% CI = 0.14–0.50, p < 0.01). The usage of PP also decreased the need for pre-operative transfusion (SMD = − 0.44, 95% CI = − 0.69 to − 0.18, p < 0.01), but had no influence on total transfusion during the first 24 h after admission (SMD = 0.05, 95% CI = − 0.43–0.54, p = 0.83) and length of hospitalization (ICU stay and total stay). Conclusions This meta-analysis indicates that a treatment protocol including PP could reduce mortality and transfusion requirement before intervention in pelvic fracture patients with hemodynamic instability vs. angiography and embolization. This latter technique could be used as a feasible and complementary technique afterwards. Level of evidence 3.https://doi.org/10.1186/s10195-022-00647-6Pelvic fractureHemodynamic instabilityPelvic packingAngioembolizationResuscitative endovascular balloon occlusion of the aorta |
| spellingShingle | Pengyu Li Fanxiao Liu Qinghu Li Dongsheng Zhou Jinlei Dong Dawei Wang Role of pelvic packing in the first attention given to hemodynamically unstable pelvic fracture patients: a meta-analysis Journal of Orthopaedics and Traumatology Pelvic fracture Hemodynamic instability Pelvic packing Angioembolization Resuscitative endovascular balloon occlusion of the aorta |
| title | Role of pelvic packing in the first attention given to hemodynamically unstable pelvic fracture patients: a meta-analysis |
| title_full | Role of pelvic packing in the first attention given to hemodynamically unstable pelvic fracture patients: a meta-analysis |
| title_fullStr | Role of pelvic packing in the first attention given to hemodynamically unstable pelvic fracture patients: a meta-analysis |
| title_full_unstemmed | Role of pelvic packing in the first attention given to hemodynamically unstable pelvic fracture patients: a meta-analysis |
| title_short | Role of pelvic packing in the first attention given to hemodynamically unstable pelvic fracture patients: a meta-analysis |
| title_sort | role of pelvic packing in the first attention given to hemodynamically unstable pelvic fracture patients a meta analysis |
| topic | Pelvic fracture Hemodynamic instability Pelvic packing Angioembolization Resuscitative endovascular balloon occlusion of the aorta |
| url | https://doi.org/10.1186/s10195-022-00647-6 |
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