{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T10:29:02Z","timestamp":1774434542984,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2009,5,19]],"date-time":"2009-05-19T00:00:00Z","timestamp":1242691200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000968","name":"American Heart Association","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000968","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2009,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There is a paucity of data regarding the impact of retroperitoneal hematoma (RPH) volumes, as detected by computed tomography (CT) scanning, on patient morbidity and mortality. Therefore, we wanted to determine the natural history of RPHs and the effect of size on local and systemic outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a volumetric analysis of CT\u2010documented RPHs managed at our institution between 1985 and 2006 along with a retrospective chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 81 cases of RPH in this study. The mean Acute Physiology, Age, and Chronic Health Evaluation II (APACHE II) score was 12.8 \u00b1 0.72 (score \u00b1 SE). By univariate analysis, the size of the hematoma showed a significant correlation with the development of local mass effects, delayed mass effects, 6\u2010month mortality, major morbidity, pulmonary complications, fluid overload, and the requirement for operative evacuation (<jats:italic>p<\/jats:italic> &lt; 0.05). Receiver operating characteristic analysis revealed that a size \u22651600\u00a0cm<jats:sup>3<\/jats:sup> was &gt;80% sensitive and specific for predicting a delayed mass effect or an increase in 6\u2010month mortality. Multivariate analysis controlling for factors such as APACHE II and packed red blood cells transfused showed that the volume of the RPH was an independent predictor for the development of local mass effects, pulmonary insufficiency, and fluid overload.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Large RPHs are clearly associated with worse patient outcomes. Surgical intervention may be warranted for the treatment of RPHs \u22651600\u00a0cm<jats:sup>3<\/jats:sup>.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-009-0048-9","type":"journal-article","created":{"date-parts":[[2009,5,18]],"date-time":"2009-05-18T18:41:16Z","timestamp":1242672076000},"page":"1618-1625","source":"Crossref","is-referenced-by-count":6,"title":["Local and Systemic Consequences of Large Retroperitoneal Clot Burdens"],"prefix":"10.1002","volume":"33","author":[{"given":"Gabriel","family":"Loor","sequence":"first","affiliation":[{"name":"Department of General Surgery University of Chicago Chicago IL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hisham","family":"Bassiouny","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery University of Chicago, The University of Chicago Hospitals 5758 S. Maryland Avenue 60637 Chicago IL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carl","family":"Valentin","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Chicago Chicago IL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael Y.","family":"Shao","sequence":"additional","affiliation":[{"name":"Department of General Surgery University of Chicago Chicago IL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian","family":"Funaki","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Chicago Chicago IL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tina","family":"Desai","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery University of Chicago, The University of Chicago Hospitals 5758 S. Maryland Avenue 60637 Chicago IL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2009,5,19]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/0741-5214(94)90227-5"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.141.8.790"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10016\u2010006\u20109059\u20102"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(77)92388\u20101"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.1810390102"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2006.11.045"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199511303332213"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005792\u2010200307000\u201000004"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007611-197605000-00034"},{"key":"e_1_2_6_11_2","first-page":"155","article-title":"Femoral neuropathy associated with anticoagulant therapy","volume":"124","author":"Wells J","year":"1977","journal-title":"Clin Orthop"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.1973.tb200008.x"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.SMJ.0000145306.59008.4E"},{"key":"e_1_2_6_14_2","first-page":"199","article-title":"Retroperitoneal hematoma with femoral neuropathy, conservative or surgical approach?","volume":"23","author":"Argibay Filgueira AB","year":"2006","journal-title":"An Med Interna"},{"key":"e_1_2_6_15_2","first-page":"706","article-title":"Percutaneous decompression for femoral neuropathy secondary to heparin\u2010induced retroperitoneal hematoma: case report and review of the literature","volume":"57","author":"Merrick HW","year":"1991","journal-title":"Am Surg"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478\u20103231.2006.01368.x"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.146.6.1289"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003246\u2010198510000\u201000009"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.272.13.1049"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000126402.51524.52"},{"key":"e_1_2_6_21_2","first-page":"127","article-title":"Reduced RBC versus plasma microvascular flow due to endotoxin","volume":"20","author":"Baker CH","year":"1986","journal-title":"Circ Shock"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199902113400601"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.97.6.562"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/MCC.0b013e32826385ef"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00268-009-0048-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00268-009-0048-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1007\/s00268-009-0048-9","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T23:28:14Z","timestamp":1704929294000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1007\/s00268-009-0048-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,5,19]]},"references-count":23,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2009,8]]}},"alternative-id":["10.1007\/s00268-009-0048-9"],"URL":"https:\/\/doi.org\/10.1007\/s00268-009-0048-9","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,5,19]]}}}