{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:43:58Z","timestamp":1777448638441,"version":"3.51.4"},"reference-count":14,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T00:00:00Z","timestamp":1757462400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The American Surgeon\u2122"],"published-print":{"date-parts":[[2026,2]]},"abstract":"\n Background<\/jats:title>\n Resuscitative endovascular balloon occlusion of the aorta (REBOA) is increasingly used for hemorrhage control in trauma patients, yet its role in blunt pelvic trauma remains controversial. This study evaluates outcomes in hypotensive patients with blunt pelvic trauma undergoing hemorrhage control surgery, comparing those who received zone 3 REBOA to those who did not.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A retrospective cohort analysis was conducted using the ACS Trauma Quality Programs Participant Use File (TQP-PUF) from 2016 to 2019. Adult patients (\u226518\u00a0years) with hypotension (SBP <100\u00a0mmHg) and blunt pelvic trauma who underwent surgical hemorrhage control were included. Exclusion criteria included traumatic brain injury, preperitoneal packing, resuscitative thoracotomy\/sternotomy, and bleeding diatheses. Propensity score matching (1:1) was used to compare patients who received zone 3 REBOA versus those who did not. Primary outcomes were 24-hour and in-hospital mortality. Secondary outcomes included transfusion volume, acute kidney injury (AKI), and lower extremity amputation.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of 4453 patients, 139 underwent REBOA. After matching, 121 patients remained per group. REBOA patients had significantly higher in-hospital mortality (50.5% vs 25.0%,\n P<\/jats:italic>\n < 0.001) and 24-hour mortality (31.0% vs 14.3%,\n P<\/jats:italic>\n = 0.002). The median PRBC transfusion was greater at 4\u00a0hours (4000\u00a0mL vs 1750\u00a0mL) and 24\u00a0hours (5600\u00a0mL vs 2800\u00a0mL) in the REBOA group (both\n P<\/jats:italic>\n < 0.001). Acute kidney injury occurred more frequently in REBOA patients (15.7% vs 6.6%,\n P<\/jats:italic>\n = 0.025).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Zone 3 REBOA in hypotensive blunt pelvic trauma was associated with higher mortality and transfusion needs. These findings highlight the need for cautious use and further prospective investigation.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/00031348251378907","type":"journal-article","created":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T00:16:03Z","timestamp":1757549763000},"page":"484-491","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Zone 3 REBOA Use in Hypotensive Patients With Blunt Pelvic Trauma Requiring Hemorrhage Control Surgery: A National Retrospective Cohort Study"],"prefix":"10.1177","volume":"92","author":[{"given":"Herbert","family":"Downton-Ramos","sequence":"first","affiliation":[{"name":"University of Connecticut School of Medicine"},{"name":"Hartford Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6883-9616","authenticated-orcid":false,"given":"Aulon","family":"Jerliu","sequence":"additional","affiliation":[{"name":"University of Connecticut School of Medicine"},{"name":"Hartford Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma","family":"Danes","sequence":"additional","affiliation":[{"name":"Hartford Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathew","family":"Lissauer","sequence":"additional","affiliation":[{"name":"Hartford Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Ricaurte","sequence":"additional","affiliation":[{"name":"Hartford Hospital"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,9,10]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.biomaterials.2022.121432"},{"key":"e_1_3_3_3_2","volume-title":"Statpearls","author":"Jennings LK","year":"2021","unstructured":"Jennings LK, Watson S. Massive transfusion. In: Statpearls. StatPearls Publishing; 2021."},{"key":"e_1_3_3_4_2","unstructured":"American Red Cross. Emergency blood shortage\u2014Donor turnout reaches lowest levels of the year amid Delta variant outbreak. https:\/\/www.redcross.org\/about-us\/news-and-events\/press-release\/2021\/emergency-blood-shortage-donor-turnout-lowest-levels.html. Accessed April 2025."},{"key":"e_1_3_3_5_2","volume-title":"Statpearls","author":"Davis DD","year":"2022","unstructured":"Davis DD, Foris LA, Kane SM, Waseem M. Pelvic fracture. In: Statpearls. StatPearls Publishing; 2022."},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2020.01.044"},{"issue":"13","key":"e_1_3_3_7_2","first-page":"11","article-title":"A descriptive survey on the use of resuscitative endovascular balloon occlusion of the aorta (REBOA) for pelvic fractures at US level I trauma centers","volume":"13","author":"Jarvis S","year":"2019","unstructured":"Jarvis S, Kelly M, Mains C, et al. A descriptive survey on the use of resuscitative endovascular balloon occlusion of the aorta (REBOA) for pelvic fractures at US level I trauma centers. Patient Saf Surg. 2019;13(13):11.","journal-title":"Patient Saf Surg"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000003053"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000001034"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/0003134820988813"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2012.04.035"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2020.06.003"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2019.0096"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000002266"},{"issue":"8","key":"e_1_3_3_15_2","first-page":"2651","article-title":"Inflate and pack! pelvic packing combined with REBOA deployment prevents hemorrhage-related deaths in unstable pelvic fractures","volume":"53","author":"Werner NL","year":"2022","unstructured":"Werner NL, Moore EE, Hoehn M, et al. Inflate and pack! pelvic packing combined with REBOA deployment prevents hemorrhage-related deaths in unstable pelvic fractures. Injury. 2022;53(8):2651-2656.","journal-title":"Injury"}],"container-title":["The American Surgeon\u2122"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348251378907","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00031348251378907","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00031348251378907","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:38:28Z","timestamp":1777379908000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00031348251378907"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,10]]},"references-count":14,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1177\/00031348251378907"],"URL":"https:\/\/doi.org\/10.1177\/00031348251378907","relation":{},"ISSN":["0003-1348","1555-9823"],"issn-type":[{"value":"0003-1348","type":"print"},{"value":"1555-9823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,10]]}}}