Utilization of angiography and embolization for abdominopelvic trauma: 14 years' experience at a level I trauma center.
OBJECTIVE
The objective of our study was to evaluate the long-term trends in the use of angiography and embolization for abdominopelvic injuries.


METHODS
Utilization rates for pelvic and abdominal angiography, arterial embolization, and CT were analyzed for trauma patients with pelvic fractures and liver and kidney injuries admitted to a level 1 trauma center from 1996 to 2010. Multivariable linear regression was used to evaluate trends in the use of angioembolization.


RESULTS
A total of 9145 patients were admitted for abdominopelvic injuries during the study period. Pelvic angiography decreased annually by 5.0% (95% CI, -6.4% to -3.7%) from 1996 to 2002 and by 1.8% (-2.4% to -1.2%) from 2003 to 2010. Embolization rates for these patients varied from 49% in 1997 to 100% in 2010. Utilization of pelvic CT on the day of admission increased significantly during this period. Abdominal angiography for liver and kidney injuries decreased annually by 3.3% (95% CI, -4.8% to -1.8%) and 2.0% (-4.3% to 0.3%) between 1996 and 2002 and by 0.8% (95% CI, -1.4% to -0.1%) and 0.9% (-2.0% to 0.1%) from 2003 to 2010, respectively. Embolization rates ranged from 25% in 1999 to 100% in 2010 for liver injuries and from 0% in 1997 to 80% in 2002 for kidney injuries. Abdominal CT for liver and kidney injuries on the day of admission also increased.


CONCLUSIONS
A significant decrease in angiography use for trauma patients with pelvic fractures, liver injuries, and kidney injuries from 1996 to 2010 and a trend toward increasing embolization rates among patients who underwent angiography were found. These findings reflect a declining role of angiography for diagnostic purposes and emphasize the importance of angiography as a means to embolization for management.
1 Department of Radiology, University of Washington School of Medicine, 325 Ninth Ave, Box 357115, Seattle, WA 98195-7115.
Bahman S
BS
Roudsari
Kevin J
KJ
Psoter
Siddharth A
SA
Padia
Matthew J
MJ
Kogut
Sharon W
SW
Kwan
D000007:Abdominal Injuries / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D004621:Embolization, Therapeutic / Q000401:mortality / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000000981:diagnostic imaging* / Q000293:injuries*; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D014193:Trauma Centers / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D014600:Utilization Review; D014861:Washington / Q000453:epidemiology; D055815:Young Adult