Quality monitoring of resuscitative endovascular balloon occlusion of the aorta using cumulative sum analysis in Korea: a case series

Purpose Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a state-of-the-art lifesaving procedure. However, due to its high mortality and morbidity, including ischemia and reperfusion injury, well-trained medical staff and effective systems are needed. This study was conducted to...

Full description

Saved in:
Bibliographic Details
Main Authors: Hyunsik Choi, Joongsuck Kim, Kwanghee Yeo, Ohsang Kwon, Kyounghwan Kim, Wu Seong Kang
Format: Article
Language:English
Published: Korean Society of Traumatology 2023-06-01
Series:Journal of Trauma and Injury
Subjects:
Online Access:http://jtraumainj.org/upload/pdf/jti-2022-0069.pdf
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850278554257850368
author Hyunsik Choi
Joongsuck Kim
Kwanghee Yeo
Ohsang Kwon
Kyounghwan Kim
Wu Seong Kang
author_facet Hyunsik Choi
Joongsuck Kim
Kwanghee Yeo
Ohsang Kwon
Kyounghwan Kim
Wu Seong Kang
author_sort Hyunsik Choi
collection DOAJ
description Purpose Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a state-of-the-art lifesaving procedure. However, due to its high mortality and morbidity, including ischemia and reperfusion injury, well-trained medical staff and effective systems are needed. This study was conducted to investigate the learning curve for REBOA in Korea. Methods To monitor this learning curve, we used cumulative sum (CUSUM) analysis and graphs of mortality and aortic occlusion time within 60, 90, and 120 minutes for consecutive patients. The procedures performed between July 2017 and June 2021 were divided into pre-trauma center (pre-TC; July 2017–February 2020) and TC (February 2020–June 2021) periods. Results REBOA was performed for 31 consecutive patients with trauma. The pre-TC (n=12) and TC (n=19) periods did not differ significantly with regard to Injury Severity Score, age, injury mechanism, initial systolic blood pressure, prehospital cardiopulmonary resuscitation (CPR), or CPR in the emergency department. At the 17th consecutive patient during the TC period, CUSUM failure graphs for mortality and aortic occlusion time exhibited a downward inflection, indicating an improvement in performance. Conclusions The mortality and aortic occlusion time of REBOA improved, and these parameters can be monitored using CUSUM analysis at the hospital level.
format Article
id doaj-art-3927dcaae9ef44439ab826cbfd66faff
institution OA Journals
issn 2799-4317
2287-1683
language English
publishDate 2023-06-01
publisher Korean Society of Traumatology
record_format Article
series Journal of Trauma and Injury
spelling doaj-art-3927dcaae9ef44439ab826cbfd66faff2025-08-20T01:49:27ZengKorean Society of TraumatologyJournal of Trauma and Injury2799-43172287-16832023-06-01362788610.20408/jti.2022.00691239Quality monitoring of resuscitative endovascular balloon occlusion of the aorta using cumulative sum analysis in Korea: a case seriesHyunsik Choi0Joongsuck Kim1Kwanghee Yeo2Ohsang Kwon3Kyounghwan Kim4Wu Seong Kang5 Department of Emergency Medicine, Jeju Regional Trauma Center, Cheju Halla General Hospital, Jeju, Korea Department of Trauma Surgery, Jeju Regional Trauma Center, Cheju Halla General Hospital, Jeju, Korea Department of Trauma Surgery, Jeju Regional Trauma Center, Cheju Halla General Hospital, Jeju, Korea Department of Trauma Surgery, Jeju Regional Trauma Center, Cheju Halla General Hospital, Jeju, Korea Department of Trauma Surgery, Jeju Regional Trauma Center, Cheju Halla General Hospital, Jeju, Korea Department of Trauma Surgery, Jeju Regional Trauma Center, Cheju Halla General Hospital, Jeju, KoreaPurpose Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a state-of-the-art lifesaving procedure. However, due to its high mortality and morbidity, including ischemia and reperfusion injury, well-trained medical staff and effective systems are needed. This study was conducted to investigate the learning curve for REBOA in Korea. Methods To monitor this learning curve, we used cumulative sum (CUSUM) analysis and graphs of mortality and aortic occlusion time within 60, 90, and 120 minutes for consecutive patients. The procedures performed between July 2017 and June 2021 were divided into pre-trauma center (pre-TC; July 2017–February 2020) and TC (February 2020–June 2021) periods. Results REBOA was performed for 31 consecutive patients with trauma. The pre-TC (n=12) and TC (n=19) periods did not differ significantly with regard to Injury Severity Score, age, injury mechanism, initial systolic blood pressure, prehospital cardiopulmonary resuscitation (CPR), or CPR in the emergency department. At the 17th consecutive patient during the TC period, CUSUM failure graphs for mortality and aortic occlusion time exhibited a downward inflection, indicating an improvement in performance. Conclusions The mortality and aortic occlusion time of REBOA improved, and these parameters can be monitored using CUSUM analysis at the hospital level.http://jtraumainj.org/upload/pdf/jti-2022-0069.pdfaortaballoon occlusionendovascular procedures
spellingShingle Hyunsik Choi
Joongsuck Kim
Kwanghee Yeo
Ohsang Kwon
Kyounghwan Kim
Wu Seong Kang
Quality monitoring of resuscitative endovascular balloon occlusion of the aorta using cumulative sum analysis in Korea: a case series
Journal of Trauma and Injury
aorta
balloon occlusion
endovascular procedures
title Quality monitoring of resuscitative endovascular balloon occlusion of the aorta using cumulative sum analysis in Korea: a case series
title_full Quality monitoring of resuscitative endovascular balloon occlusion of the aorta using cumulative sum analysis in Korea: a case series
title_fullStr Quality monitoring of resuscitative endovascular balloon occlusion of the aorta using cumulative sum analysis in Korea: a case series
title_full_unstemmed Quality monitoring of resuscitative endovascular balloon occlusion of the aorta using cumulative sum analysis in Korea: a case series
title_short Quality monitoring of resuscitative endovascular balloon occlusion of the aorta using cumulative sum analysis in Korea: a case series
title_sort quality monitoring of resuscitative endovascular balloon occlusion of the aorta using cumulative sum analysis in korea a case series
topic aorta
balloon occlusion
endovascular procedures
url http://jtraumainj.org/upload/pdf/jti-2022-0069.pdf
work_keys_str_mv AT hyunsikchoi qualitymonitoringofresuscitativeendovascularballoonocclusionoftheaortausingcumulativesumanalysisinkoreaacaseseries
AT joongsuckkim qualitymonitoringofresuscitativeendovascularballoonocclusionoftheaortausingcumulativesumanalysisinkoreaacaseseries
AT kwangheeyeo qualitymonitoringofresuscitativeendovascularballoonocclusionoftheaortausingcumulativesumanalysisinkoreaacaseseries
AT ohsangkwon qualitymonitoringofresuscitativeendovascularballoonocclusionoftheaortausingcumulativesumanalysisinkoreaacaseseries
AT kyounghwankim qualitymonitoringofresuscitativeendovascularballoonocclusionoftheaortausingcumulativesumanalysisinkoreaacaseseries
AT wuseongkang qualitymonitoringofresuscitativeendovascularballoonocclusionoftheaortausingcumulativesumanalysisinkoreaacaseseries