title: Ilio-psoas hematoma in the intensive care unit: a multicentric study.
abstract: BACKGROUND
  Clinical features and outcomes of patients with spontaneous ilio-psoas hematoma (IPH) in intensive care units (ICUs) are poorly documented. The objectives of this study were to determine epidemiological, clinical, biological and management characteristics of ICU patients with IPH.
  
  
  METHODS
  We conducted a retrospective multicentric study in three French ICUs from January 2006 to December 2014. We included IPH diagnosed both at admission and during ICU stay. Surgery and embolization were available 24 h a day for each center, and therapeutic decisions were undertaken after pluridisciplinary discussion. All IPHs were diagnosed using CT scan.
  
  
  RESULTS
  During this period, we identified 3.01 cases/1000 admissions. The mortality rate of the 77 included patients was 30 %. In multivariate analysis, we observed that mortality was independently associated with SAPS II (OR 1.1, 95 % CI [1.013-1.195], p = 0.02) and with the presence of hemorrhagic shock (OR 67.1, 95 % CI [2.6-1691], p = 0.01). We found IPH was related to anticoagulation therapy in 56 cases (72 %), with guideline-concordant reversal performed in 33 % of patients. We did not found any association between anticoagulant therapy type and outcome.
  
  
  CONCLUSIONS
  We found IPH is an infrequent disease, with a high mortality rate of 30 %, mostly related to anticoagulation therapy and usually affecting the elderly. Management of anticoagulation-related IPH includes a high rate of no reversal of 38 %.
authors.affiliation: Medical Intensive Care Unit, Cochin Hospital, Groupe Hospitalier Cochin Broca Hôtel-Dieu, Assistance Publique des Hôpitaux de Paris, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France. jllitjos@gmail.com.|Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, 15 rue de l'Ecole de Médecine, 75006, Paris, France. jllitjos@gmail.com.
authors.forename: J F
authors.initials: JF
authors.lastname: Llitjos
authors.affiliation: Medical Intensive Care Unit, Cochin Hospital, Groupe Hospitalier Cochin Broca Hôtel-Dieu, Assistance Publique des Hôpitaux de Paris, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France.|Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, 15 rue de l'Ecole de Médecine, 75006, Paris, France.
authors.forename: F
authors.initials: F
authors.lastname: Daviaud
authors.affiliation: Medical Intensive Care Unit, Cochin Hospital, Groupe Hospitalier Cochin Broca Hôtel-Dieu, Assistance Publique des Hôpitaux de Paris, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France.|Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, 15 rue de l'Ecole de Médecine, 75006, Paris, France.
authors.forename: D
authors.initials: D
authors.lastname: Grimaldi
authors.affiliation: Intensive Care Unit, Hôpital de Versailles - Site André Mignot, 177 rue de Versailles, 78150, Le Chesnay Cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Legriel
authors.affiliation: Cardiology, Hôpital de Versailles - Site André Mignot, 177 rue de Versailles, 78150, Le Chesnay Cedex, France.
authors.forename: J L
authors.initials: JL
authors.lastname: Georges
authors.affiliation: Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, 15 rue de l'Ecole de Médecine, 75006, Paris, France.|Medical Intensive Care Unit, Hôpital Européen Georges Pompidou, AP-HP, Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Guerot
authors.affiliation: Intensive Care Unit, Hôpital de Versailles - Site André Mignot, 177 rue de Versailles, 78150, Le Chesnay Cedex, France.
authors.forename: J P
authors.initials: JP
authors.lastname: Bedos
authors.affiliation: Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, 15 rue de l'Ecole de Médecine, 75006, Paris, France.|Medical Intensive Care Unit, Hôpital Européen Georges Pompidou, AP-HP, Paris, France.
authors.forename: J Y
authors.initials: JY
authors.lastname: Fagon
authors.affiliation: Medical Intensive Care Unit, Cochin Hospital, Groupe Hospitalier Cochin Broca Hôtel-Dieu, Assistance Publique des Hôpitaux de Paris, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France.|Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, 15 rue de l'Ecole de Médecine, 75006, Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Charpentier
authors.affiliation: Medical Intensive Care Unit, Cochin Hospital, Groupe Hospitalier Cochin Broca Hôtel-Dieu, Assistance Publique des Hôpitaux de Paris, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France.|Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, 15 rue de l'Ecole de Médecine, 75006, Paris, France.
authors.forename: J P
authors.initials: JP
authors.lastname: Mira
keywords: Anticoagulant therapy; Ilio-psoas hematoma; Intensive care; Psoas; Reversal