{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T06:53:29Z","timestamp":1791442409148,"version":"4.3.3"},"reference-count":33,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T00:00:00Z","timestamp":1791331200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp;amp; Neck"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Carotid blowout syndrome (CBS) is a life\u2010threatening complication of head and neck cancer (HNC). This study evaluated clinical outcomes and prognostic factors in patients with HNC who presented to the emergency department (ED) with CBS and underwent endovascular management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective, multi\u2010institutional observational study across four hospitals in Taiwan from January 1, 2011, to December 31, 2023. Adult patients with HNC who presented to the ED with bleeding suggestive of CBS on computed tomography angiography underwent endovascular therapy and had the diagnosis confirmed by digital subtraction angiography were included. The primary endpoint was in\u2010hospital mortality. Independent prognostic factors were identified using multivariable logistic regression, and a predictive nomogram was constructed and internally validated by bootstrap resampling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 348 patients were included. Most were male (93.7%), had Stage IV disease (74.7%), and were treated with arterial embolization (93.4%). In\u2010hospital mortality occurred in 57 patients (16.4%). The estimated 30\u2010day and 1\u2010year survival rates were 84.8% and 51.7%, respectively. In multivariable analysis, vasopressor use (odds ratio [OR], 6.54), failed hemostasis (OR, 4.68), tracheostomy status (OR, 2.04), multivessel involvement (OR, 1.98), and lower systolic blood pressure (OR, 0.99 per mmHg) were independently associated with in\u2010hospital mortality. The nomogram showed moderate discrimination with a\n                      <jats:italic>C<\/jats:italic>\n                      \u2010statistic of 0.73.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among patients with HNC presenting to the ED with CBS and undergoing endovascular management, in\u2010hospital mortality remained substantial. A nomogram incorporating readily available clinical and imaging variables may assist early risk stratification after ED presentation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.70488","type":"journal-article","created":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T06:28:00Z","timestamp":1791440880000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic Outcomes Following Endovascular Management for Carotid Blowout Syndrome: A Multi\u2010Institutional Observational Cohort Study"],"prefix":"10.1002","author":[{"given":"Szu\u2010Cheng","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine New Taipei Municipal Tucheng Hospital  New Taipei City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6187-4102","authenticated-orcid":false,"given":"Yi\u2010Chieh","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery New Taipei Municipal Tucheng Hospital  New Taipei City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Chen","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology Chang Gung Memorial Hospital  Keelung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0984-8385","authenticated-orcid":false,"given":"Chen\u2010June","family":"Seak","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine New Taipei Municipal Tucheng Hospital  New Taipei City Taiwan"},{"name":"College of Medicine Chang Gung University  Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4885-8175","authenticated-orcid":false,"given":"Chieh\u2010Ching","family":"Yen","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine New Taipei Municipal Tucheng Hospital  New Taipei City Taiwan"},{"name":"College of Medicine Chang Gung University  Taoyuan Taiwan"},{"name":"Department of Emergency Medicine Chang Gung Memorial Hospital, Linkou Branch  Taoyuan 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