[논문]Quality monitoring of resuscitative endovascular balloon occlusion of the aorta using cumulative sum analysis in Korea: a case series

Hyunsik Choi; Joongsuck Kim; Kwanghee Yeo; Ohsang Kwon; Kyounghwan Kim; Wu Seong Kang

doi:10.20408/jti.2022.0069

Quality monitoring of resuscitative endovascular balloon occlusion of the aorta using cumulative sum analysis in Korea: a case series 원문보기

Journal of trauma and injury : JTI, v.36 no.2, 2023년, pp.78 - 86

Hyunsik Choi (Department of Emergency Medicine, Jeju Regional Trauma Center, Cheju Halla General Hospital) , Joongsuck Kim (Department of Trauma Surgery, Jeju Regional Trauma Center, Cheju Halla General Hospital) , Kwanghee Yeo (Department of Trauma Surgery, Jeju Regional Trauma Center, Cheju Halla General Hospital) , Ohsang Kwon (Department of Trauma Surgery, Jeju Regional Trauma Center, Cheju Halla General Hospital) , Kyounghwan Kim (Department of Trauma Surgery, Jeju Regional Trauma Center, Cheju Halla General Hospital) , Wu Seong Kang (Department of Trauma Surgery, Jeju Regional Trauma Center, Cheju Halla General Hospital)

Abstract ▼ AI-Helper

Purpose: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a state-of-the-art lifesaving procedure. However, due to its high mortality and morbidity, including ischemia and reperfusion injury, well-trained medical staff and effective systems are needed. This study was conducted to investigate the learning curve for REBOA in Korea. Methods: To monitor this learning curve, we used cumulative sum (CUSUM) analysis and graphs of mortality and aortic occlusion time within 60, 90, and 120 minutes for consecutive patients. The procedures performed between July 2017 and June 2021 were divided into pre-trauma center (pre-TC; July 2017-February 2020) and TC (February 2020-June 2021) periods. Results: REBOA was performed for 31 consecutive patients with trauma. The pre-TC (n=12) and TC (n=19) periods did not differ significantly with regard to Injury Severity Score, age, injury mechanism, initial systolic blood pressure, prehospital cardiopulmonary resuscitation (CPR), or CPR in the emergency department. At the 17th consecutive patient during the TC period, CUSUM failure graphs for mortality and aortic occlusion time exhibited a downward inflection, indicating an improvement in performance. Conclusions: The mortality and aortic occlusion time of REBOA improved, and these parameters can be monitored using CUSUM analysis at the hospital level.

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표/그림 (6)

표 Table 1. Comparison between pre-TC and TC period
표 Table 2. Comparison between nonsurvivor and survivor (n=31)
그림 Fig. 1. Cumulative sum (CUSUM) failure graph for patient survival. (A) The scatter plot of aortic occlusion time and (B) CUSUM graph. The dotted line denotes the establishment of a regional trauma center (pre-trauma center period, patient no. 1-12; trauma center period, patient no. 13-31).
그림 Fig. 2. Cumulative sum (CUSUM) failure graph for aortic occlusion time ≤60 minutes. (A) The scatter plot of aortic occlusion time and (B) CUSUM graph. The dotted line denotes the establishment of a regional trauma center (pre-trauma center period, patient no. 1-12; trauma center period, patient no. 13-31).
그림 Fig. 3. Cumulative sum (CUSUM) failure graph for aortic occlusion time ≤90 minutes. (A) The scatter plot of aortic occlusion time and (B) CUSUM graph. The dotted line denotes the establishment of a regional trauma center (pre-trauma center period, patient no. 1-12; trauma center period, patient no. 13-31).
그림 Fig. 4. Cumulative sum (CUSUM) failure graph for aortic occlusion time ≤120 minutes. (A) The scatter plot of aortic occlusion time and (B) CUSUM graph.The dotted line denotes the establishment of a regional trauma center (pre-trauma center period, patient no. 1-12; trauma center period, patient no. 13-31).

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Quality monitoring of resuscitative endovascular balloon occlusion of the aorta using cumulative sum analysis in Korea: a case series 원문보기

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Quality monitoring of resuscitative endovascular balloon occlusion of the aorta using cumulative sum analysis in Korea: a case series 원문보기

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