{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T13:21:34Z","timestamp":1775913694794,"version":"3.50.1"},"reference-count":33,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Building on prior findings that active vascular contrast extravasation (AVCE) size is an independent predictor of in-hospital mortality in abdominopelvic hemorrhages, this study aimed to categorize AVCEs using latent profile analysis (LPA) and examine differences in patient characteristics, treatments, and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively included consecutive adults with CT-detected AVCE between January 2019 and May 2022. LPA was applied to classify AVCEs based on size-related features, optimizing the number of classes predictive of 24-h and in-hospital mortality. These classes were compared using univariable analysis with post-hoc pairwise comparisons to identify significant differences. Cutoff values for categorization were derived from size parameters and changes across arterial (AP) and portovenous (PVP) phases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      LPA classified 223 patients with single-organ, traumatic, and nontraumatic AVCEs (mean age 59.8\u2009\u00b1\u200920.1 years, 123 men) into three groups-slow (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009136), moderate (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200975), and rapid (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200912). Slow AVCEs showed smaller size parameters and minimal changes between AP and delayed phases. Rapid AVCEs frequently exhibited coexisting pseudoaneurysms, smaller areas on AP, lower mean attenuation differences in AP-PVP pairs, and were associated with lower systolic and diastolic blood pressures, requiring the highest quantity of packed red cells. Perimeter percentage changes between AP and PVP performed comparably to LPA classes and provided practical classification cutoffs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>LPA-based classification of AVCEs into slow, moderate, and rapid types revealed distinct size patterns and associated clinical outcomes, offering a robust framework for risk stratification and guiding management of abdominopelvic hemorrhages.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Question<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>It is unclear if the size of active vascular contrast extravasation (AVCE) is predictive of mortality in patients with abdominopelvic hemorrhage.<\/jats:italic>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Findings<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>AVCEs could be classified by latent profile analysis into three groups: slow, moderate, and rapid, based on size at multiphasic CT with distinct mortality risks.<\/jats:italic>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Clinical relevance<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>Practical cutoff values of perimeter percentage changes of AVCE between arterial- and portovenous-phase CT were identified for AVCE classification, potentially guiding clinical prioritization and management of patients with abdominopelvic hemorrhage.<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s00330-025-11693-z","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T14:28:45Z","timestamp":1747837725000},"page":"6669-6681","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Rapid, moderate, or slow bleeding? 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The retrospective single-center study was approved by our Institutional Review Board (COA. No. Si 555\/2022).","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"We would like to clarify that the current study used a subset of patients from another original article, which has been published [\n                      \n                      ]. This manuscript is not a companion paper to the other one. The current submission categorized bleeding spaces in the abdomen and pelvis into three classes based on multiphase CT findings and mortality rates, which included 223 patients. The other examined a different research question but utilized a larger patient cohort (\n                      n\n                      \u2009=\u2009272) to investigate factors and pathways associated with in-hospital mortality among patients with this condition. These two studies have distinct research objectives and are not duplicates.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Study subjects or cohorts overlap"}},{"order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}