{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T19:20:30Z","timestamp":1790623230216,"version":"4.1.0"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Trauma Acute Care Surg"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec>\n            <jats:title>BACKGROUND<\/jats:title>\n            <jats:p>The objective was to assess the predictive performance of different intravascular contrast extravasation (ICE) characteristics for need for pelvic transarterial embolization (TAE) to determine the risk factors of false positives.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>METHODS<\/jats:title>\n            <jats:p>A retrospective study was performed in our trauma center between 2010 and 2015. All severe trauma patients with pelvic fracture were included. Pelvic ICE characteristics on computed tomography (CT) scan were studied: arterial (aS<jats:sup>2<\/jats:sup>\n                                 <jats:sub>ICE<\/jats:sub>), portal surface (pS<jats:sup>2<\/jats:sup>\n                                 <jats:sub>ICE<\/jats:sub>), and extension (exS<jats:sup>2<\/jats:sup>\n                                 <jats:sub>ICE<\/jats:sub>) anatomic relationships. The overall predictive performance of ICE surfaces for pelvic TAE was analyzed using receiver operating characteristic curves. The analysis focused on risk factors for false positives.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>RESULTS<\/jats:title>\n            <jats:p>Among 311 severe trauma patients with pelvic ring fracture (mean age, 42 \u00b1 19 years; mean Injury Severity Score, 27 \u00b1 19), 94 (30%) had at least one pelvic ICE on the initial CT scan. Patients requiring pelvic TAE had significantly larger aS<jats:sup>2<\/jats:sup>\n                                 <jats:sub>ICE<\/jats:sub> and pS<jats:sup>2<\/jats:sup>\n                                 <jats:sub>ICE<\/jats:sub> than others (<jats:italic toggle=\"yes\">p<\/jats:italic> = 0.001 and <jats:italic toggle=\"yes\">p<\/jats:italic> = 0.035, respectively). The overall ability of ICE surfaces to predict pelvic TAE was modest (aS<jats:sup>2<\/jats:sup>\n                                 <jats:sub>ICE<\/jats:sub> area under the receiver operating characteristic curve, 0.76 [95% confidence interval, 0.64\u20130.90]; <jats:italic toggle=\"yes\">p<\/jats:italic> = 0.011) or nonsignificant (pS<jats:sup>2<\/jats:sup>\n                                 <jats:sub>ICE<\/jats:sub> and exS<jats:sup>2<\/jats:sup>\n                                 <jats:sub>ICE<\/jats:sub>). The high-sensitivity threshold was defined as aS<jats:sup>2<\/jats:sup>\n                                 <jats:sub>ICE<\/jats:sub> 20 mm<jats:sup>2<\/jats:sup> or more. Using this threshold, 76% of patients were false positives. Risk factors for false positives were admission systolic blood pressure of 90 mm Hg or greater (63% vs 20%; <jats:italic toggle=\"yes\">p<\/jats:italic> = 0.03) and low transfusion needs (63% vs 10%; <jats:italic toggle=\"yes\">p<\/jats:italic> = 0.009), extravasation in contact with complex bone fracture (78% vs 30%; <jats:italic toggle=\"yes\">p<\/jats:italic> = 0.008), or the absence of a direct relationship between extravasation and a large retroperitoneal hematoma (100% vs 38%; <jats:italic toggle=\"yes\">p<\/jats:italic> &lt; 0.001).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>CONCLUSION<\/jats:title>\n            <jats:p>A significant pelvic ICE during the arterial phase does not guarantee the need for pelvic TAE. Three quarters of patients with aS<jats:sup>2<\/jats:sup>\n                                 <jats:sub>ICE<\/jats:sub> of 20 mm<jats:sup>2<\/jats:sup> or more did not need pelvic TAE. Several complementary CT scan criteria will help to identify this risk of false positives to determine adequate hemostatic pelvic procedures.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>LEVEL OF EVIDENCE<\/jats:title>\n            <jats:p>Therapeutic study, level IV.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/ta.0000000000002001","type":"journal-article","created":{"date-parts":[[2018,6,13]],"date-time":"2018-06-13T18:40:46Z","timestamp":1528915246000},"page":"527-535","source":"Crossref","is-referenced-by-count":17,"title":["Limits of intravascular contrast extravasation on computed tomography scan to define the need for pelvic angioembolization in pelvic blunt trauma: a specific assessment on the risk of false positives"],"prefix":"10.1097","volume":"85","author":[{"given":"S\u00e9verin","family":"Ramin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaux","family":"Hermida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid","family":"Millet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thibault","family":"Murez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie","family":"Monnin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mazen","family":"Hamoui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Capdevila","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Charbit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"issue":"5","key":"bib1-20230825","first-page":"1066","article-title":"The epidemiology of pelvic ring fractures: a population-based study","volume":"63","year":"2007","journal-title":"J Trauma"},{"issue":"4","key":"bib2-20230825","first-page":"875","article-title":"Prevalence of pelvic fractures, associated injuries, and mortality: the United Kingdom perspective","volume":"63","year":"2007","journal-title":"J Trauma"},{"issue":"2","key":"bib3-20230825","first-page":"449","article-title":"Mortality in patients with pelvic fractures: results from the German pelvic injury register","volume":"64","year":"2008","journal-title":"J Trauma"},{"issue":"5","key":"bib4-20230825","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.crad.2013.12.016","article-title":"Emergency computed tomography for acute pelvic trauma: where is the bleeder?","volume":"69","year":"2014","journal-title":"Clin Radiol"},{"issue":"2","key":"bib5-20230825","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1097\/TA.0000000000000094","article-title":"Management of pelvic ring fracture patients with a pelvic \u201cblush\u201d on early computed tomography","volume":"76","year":"2014","journal-title":"J Trauma Acute Care Surg"},{"key":"bib6-20230825","article-title":"Preperitoneal pelvic packing reduces mortality in patients with life-threatening hemorrhage due to unstable pelvic fractures","year":"2016","journal-title":"J Trauma Acute Care Surg"},{"issue":"5","key":"bib7-20230825","first-page":"1012","article-title":"Western Trauma Association critical decisions in trauma: management of pelvic fracture with hemodynamic instability","volume":"65","year":"2008","journal-title":"J Trauma"},{"key":"bib8-20230825","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1186\/s13054-016-1265-x","article-title":"The European guideline on management of major bleeding and coagulopathy following trauma: fourth edition","volume":"20","year":"2016","journal-title":"Crit Care Lond Engl"},{"key":"bib9-20230825","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/s13017-017-0117-6","article-title":"Pelvic trauma: WSES classification and guidelines","volume":"12","year":"2017","journal-title":"World J Emerg Surg"},{"issue":"1\u20132","key":"bib10-20230825","first-page":"29","article-title":"[Spiral computed tomography in the assessment of vascular lesions of the pelvis due to blunt trauma]","volume":"100","year":"2000","journal-title":"Radiol Med"},{"issue":"4","key":"bib11-20230825","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1007\/s11547-010-0494-0","article-title":"Role of multidetector-row CT in assessing the source of arterial haemorrhage in patients with pelvic vascular trauma. 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