Minimising the biases in the observational study of resuscitative endovascular balloon occlusion of the aorta: a research protocol for a prospective study analysed with propensity score matching with time-varying covariates

Introduction Resuscitative endovascular balloon occlusion of the aorta (REBOA) has been used as a bridge to definitive bleeding control of subdiaphragmatic injury. Since previous observational studies have poorly adjusted for confounding factors, it is necessary to incorporate REBOA-specific and tim...

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Main Authors: Yosuke Matsumura, Shigeki Kushimoto, Atsushi Shiraishi
Format: Article
Language:English
Published: BMJ Publishing Group 2022-04-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/12/4/e053743.full
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author Yosuke Matsumura
Shigeki Kushimoto
Atsushi Shiraishi
author_facet Yosuke Matsumura
Shigeki Kushimoto
Atsushi Shiraishi
author_sort Yosuke Matsumura
collection DOAJ
description Introduction Resuscitative endovascular balloon occlusion of the aorta (REBOA) has been used as a bridge to definitive bleeding control of subdiaphragmatic injury. Since previous observational studies have poorly adjusted for confounding factors, it is necessary to incorporate REBOA-specific and time-varying covariates in the model. We hypothesised that REBOA improves the survival of haemodynamically unstable torso trauma patients after comparing the REBOA group with a matched control group (non-REBOA group).Methods and analysis The Japanese Association for the Surgery of Trauma-REBOA Study is a prospective, multicentre, matched cohort study organised by the Clinical Trial Committee of the Japanese Association for the Surgery of Trauma. To minimise observational study biases, this study will prospectively register traumatic shock patients who require bleeding control within 60 min upon arrival at the emergency department, with in-hospital mortality as the primary outcome. After the data set is fixed, the missing values for all variables will be imputed using the multiple imputation technique. In the primary analysis, propensity scores for the probability of REBOA decision (regardless of the actual REBOA deployment) will be calculated from the baseline information using a logistic regression generalised linear mixed-effects model, which will be performed for both the REBOA use and non-REBOA use groups.Ethics and dissemination This study was approved by the ethics committee of each participating hospital. The results will be disseminated to the participating hospitals, submitted to peer-reviewed journals for publication and presented at congresses.Trial registration number UMIN Clinical Trials Registry (UMIN000035458).
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spelling doaj-art-e923ec3c6a0c4801b777dc0b201895802025-08-20T02:11:25ZengBMJ Publishing GroupBMJ Open2044-60552022-04-0112410.1136/bmjopen-2021-053743Minimising the biases in the observational study of resuscitative endovascular balloon occlusion of the aorta: a research protocol for a prospective study analysed with propensity score matching with time-varying covariatesYosuke Matsumura0Shigeki Kushimoto1Atsushi Shiraishi2Department of Emergency and Critical Care Medicine, Chiba University Graduate School of Medicine, Chiba, JapanDivision of Emergency and Critical Care Medicine, Tohoku University, Sendai, Miyagi, JapanEmergency and Trauma Department, Kameda Medical Center, Kamogawa, JapanIntroduction Resuscitative endovascular balloon occlusion of the aorta (REBOA) has been used as a bridge to definitive bleeding control of subdiaphragmatic injury. Since previous observational studies have poorly adjusted for confounding factors, it is necessary to incorporate REBOA-specific and time-varying covariates in the model. We hypothesised that REBOA improves the survival of haemodynamically unstable torso trauma patients after comparing the REBOA group with a matched control group (non-REBOA group).Methods and analysis The Japanese Association for the Surgery of Trauma-REBOA Study is a prospective, multicentre, matched cohort study organised by the Clinical Trial Committee of the Japanese Association for the Surgery of Trauma. To minimise observational study biases, this study will prospectively register traumatic shock patients who require bleeding control within 60 min upon arrival at the emergency department, with in-hospital mortality as the primary outcome. After the data set is fixed, the missing values for all variables will be imputed using the multiple imputation technique. In the primary analysis, propensity scores for the probability of REBOA decision (regardless of the actual REBOA deployment) will be calculated from the baseline information using a logistic regression generalised linear mixed-effects model, which will be performed for both the REBOA use and non-REBOA use groups.Ethics and dissemination This study was approved by the ethics committee of each participating hospital. The results will be disseminated to the participating hospitals, submitted to peer-reviewed journals for publication and presented at congresses.Trial registration number UMIN Clinical Trials Registry (UMIN000035458).https://bmjopen.bmj.com/content/12/4/e053743.full
spellingShingle Yosuke Matsumura
Shigeki Kushimoto
Atsushi Shiraishi
Minimising the biases in the observational study of resuscitative endovascular balloon occlusion of the aorta: a research protocol for a prospective study analysed with propensity score matching with time-varying covariates
BMJ Open
title Minimising the biases in the observational study of resuscitative endovascular balloon occlusion of the aorta: a research protocol for a prospective study analysed with propensity score matching with time-varying covariates
title_full Minimising the biases in the observational study of resuscitative endovascular balloon occlusion of the aorta: a research protocol for a prospective study analysed with propensity score matching with time-varying covariates
title_fullStr Minimising the biases in the observational study of resuscitative endovascular balloon occlusion of the aorta: a research protocol for a prospective study analysed with propensity score matching with time-varying covariates
title_full_unstemmed Minimising the biases in the observational study of resuscitative endovascular balloon occlusion of the aorta: a research protocol for a prospective study analysed with propensity score matching with time-varying covariates
title_short Minimising the biases in the observational study of resuscitative endovascular balloon occlusion of the aorta: a research protocol for a prospective study analysed with propensity score matching with time-varying covariates
title_sort minimising the biases in the observational study of resuscitative endovascular balloon occlusion of the aorta a research protocol for a prospective study analysed with propensity score matching with time varying covariates
url https://bmjopen.bmj.com/content/12/4/e053743.full
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