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Invited Commentary
March 20, 2019

The Need to Better Define the Who, What, and Where of Resuscitative Endovascular Balloon Occlusion of the Aorta

Author Affiliations
  • 1Department of Surgery, University of Florida, Gainesville
  • 2Division of Acute Care Surgery, Department of Surgery, University of Florida, Gainesville
JAMA Surg. 2019;154(6):508-509. doi:10.1001/jamasurg.2019.0101

In this issue of JAMA Surgery, Joseph et al1 examine the outcomes in trauma patients after resuscitative endovascular balloon occlusion of the aorta (REBOA) placement using 2 years of the American College of Surgeons Trauma Quality Improvement Program (ACS-TQIP) data set. The results demonstrate that patients in a propensity-matched cohort (140 patients in the REBOA group and 280 patients in the no-REBOA group) who underwent REBOA had a higher 24-hour mortality rate, acute kidney injury rate, and amputation rate. Yet, there was no difference in mortality in the emergency department or mortality after 24 hours in the hospital. In addition, there were no differences in transfusion requirements or intensive care unit and hospital lengths of stay. There was also no difference in survival based on REBOA and the need for further angioembolization or exploratory laparotomy procedures. The authors conclude by stating there is a significant “need for a concerted effort to clearly define when and in which patient population REBOA has a benefit.”

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