Predictors of Mortality from Spontaneous Soft-Tissue Hematomas in a Large Multicenter Cohort Who Underwent Percutaneous Transarterial Embolization

Purpose: To evaluate the safety and efficacy of percutaneous transarterial embolization (PTAE) for the treatment of spontaneous soft-tissue hematomas (SSTHs) and identify variables predictive of short-term outcome. Materials and Methods: Between 2011 and 2017, the outcome was retrospectively analyzed for 112 patients (mean age standard deviation, 72 years +/- 14; range, 28-92 years), including 65 women (mean age, 73 years +/- 12.7: range, 39-92 wars) and 47 men (mean age, 70 years +/- 14.9; range, 28-91 years), with SSTH treated with PTAE. Thirty-day mortality, technical and clinical sue - eras, simplified acute physiology score (SAPS) II, anticoagulation, embolic agent, hematoma volume and location, serum hemoglo- bin hemodynamic instability, and presence of active bleeding at CT and/or angiography were recorded. Clinical success WAS defined as cessation of bleeding as determined by hemmodynamic stability and/or serum hemoglobin level stabilization after PTAE. Univariable and multivariable analyses were performed by using a Cox model to identify variables associated with time to death. Results: Mortality rate was 26.8% (30 of 112 patients), angiographic success rate was 95.5% (107 of 112 patients), and clinical success rate was 8. (93 of 112 patients). For surviving patients, mean SAPS II was 19.6 +/- 7.1 (range, 13-31) and mean hematoma volume was 862 cm(3)+/- 618 (range, 238-1887 cm(3)). For deceased patients, mean SAPS II was 42 +/- 13.2 (range, 18-63) and mean hematoma volume was 1419cm(3) +/- 788 (range, 251-3492 cm(3)). SAPS II (P < .001), hematoma volume (P =.01), and renoperito- neal location (P = .01) were independently associated with fatal outcome. Conclusion: Percutaneous transarterial embolization is effective for the emergency treatment spontaneous soft-tissue hematomas. Simplified acute physiology score II, hematoma volume, and rerroperitoneal location are predictors of short-term outcome. (C) RSNA, 2019