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Purpose <p>To determine whether time of arrival at a major trauma centre (MTC) influences embolisation rate, time to embolisation, embolisation failure and 30-day survival in adult trauma patients.</p> Materials and Methods <p>Data for adults (&gt; 18&#xa0;years) admitted to an MTC and recorded in the UK Trauma Audit and Research Network database between 01/01/17 and 31/12/21 were analysed. ‘In-hours’ was defined as Monday to Friday (excluding holidays) 09:00–17:00; all other times were ‘out-of-hours’. Descriptive and regression analyses assessed factors associated with time to embolisation and 30-day survival, and the relationship between these outcomes.</p> Results <p>Among 2,560 patients with splenic injury (Abbreviated Injury Scale (AIS) &gt; 2) directly admitted to an MTC, 184 (7.2%) underwent embolisation within 24&#xa0;h. Of these, 79% were male (145/184) with a median age of 42&#xa0;years (IQR 27–56). Embolisation within 24&#xa0;h occurred in 48/600 (8.0%) of patients admitted in-hours versus 136/1,960 (6.9%) out-of-hours. Embolisation failure rate was similar between the groups (6.3% (3/48) in-hours&#xa0;versus&#xa0;9.6% (13/136) out-of-hours). American Association for the Surgery of Trauma (AAST) grade and probability of survival were similar across groups. Median time to embolisation was 159&#xa0;min (95% CI 142–213) in-hours and 238&#xa0;min (95% CI 210–288) out-of-hours. After adjustment, out-of-hours patients had 1.34 times longer time to embolisation (95% CI 1.02–1.76). Regression analysis showed no strong association between time of admission and 30-day survival (odds ratio [OR] 2.13; 95% CI 0.76–5.81). Time to embolisation also showed no relationship with survival (OR 1.00; 95% CI 1.00–1.00).</p> Conclusion <p>Although out-of-hours presentation delayed embolisation, this did not affect 30-day survival, suggesting current trauma workflows maintain clinical effectiveness despite temporal disparities in interventional radiology (IR) access.</p> Graphical Abstract <p></p>

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Time to Splenic Embolisation in Trauma Patients Arriving at a Major Trauma Centre In-Hours or Out-of-Hours: A UK Multicentre Study

  • 期刊论文

  • 发表日期：

    2026年1月16日

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  • P. Jenkins,
  • A. See,
  • A. Barnett,
  • E. Wilson,
  • D. Kotecha,
  • L. Sorrell,
  • V. Allgar,
  • J. E. Smith,
  • C. Roobottom

摘要

Purpose

To determine whether time of arrival at a major trauma centre (MTC) influences embolisation rate, time to embolisation, embolisation failure and 30-day survival in adult trauma patients.

Materials and Methods

Data for adults (> 18 years) admitted to an MTC and recorded in the UK Trauma Audit and Research Network database between 01/01/17 and 31/12/21 were analysed. ‘In-hours’ was defined as Monday to Friday (excluding holidays) 09:00–17:00; all other times were ‘out-of-hours’. Descriptive and regression analyses assessed factors associated with time to embolisation and 30-day survival, and the relationship between these outcomes.

Results

Among 2,560 patients with splenic injury (Abbreviated Injury Scale (AIS) > 2) directly admitted to an MTC, 184 (7.2%) underwent embolisation within 24 h. Of these, 79% were male (145/184) with a median age of 42 years (IQR 27–56). Embolisation within 24 h occurred in 48/600 (8.0%) of patients admitted in-hours versus 136/1,960 (6.9%) out-of-hours. Embolisation failure rate was similar between the groups (6.3% (3/48) in-hours versus 9.6% (13/136) out-of-hours). American Association for the Surgery of Trauma (AAST) grade and probability of survival were similar across groups. Median time to embolisation was 159 min (95% CI 142–213) in-hours and 238 min (95% CI 210–288) out-of-hours. After adjustment, out-of-hours patients had 1.34 times longer time to embolisation (95% CI 1.02–1.76). Regression analysis showed no strong association between time of admission and 30-day survival (odds ratio [OR] 2.13; 95% CI 0.76–5.81). Time to embolisation also showed no relationship with survival (OR 1.00; 95% CI 1.00–1.00).

Conclusion

Although out-of-hours presentation delayed embolisation, this did not affect 30-day survival, suggesting current trauma workflows maintain clinical effectiveness despite temporal disparities in interventional radiology (IR) access.

Graphical Abstract