307 - Critical Role of Interventional Radiology in the Acute Care of Trauma Patients: A Quantitative Retrospective Analysis

Purpose: To retrospectively evaluate the role of interventional radiology (IR) in the care of patients after trauma activation, both penetrating and blunt, by quantifying the number and types of procedures performed at a level I trauma center.

Materials and Methods: All patients who presented for trauma activation and went to IR during fiscal year 2025 (between July 1, 2024 and June 30, 2025) were included in the study. Patients were then excluded if they had an Injury Severity Score (ISS) less than 16, widely accepted as a threshold for major trauma. Patient charts were queried for any procedure performed by IR between day 0 of presentation and 1-year post-admission. Procedures were categorized as vascular access related, angiographic, venographic, drainage, enteral access, and neuro-interventional.

Results: During this period, without censoring for ISS score, 2,253 patients (595 penetrating, 1,658 blunt) presented with trauma activation. IR performed a procedure on 115/2,253 trauma patients (5.1%), 72/595 penetrating trauma patients (12.1%), and 89/1,658 blunt trauma patients (5.4%). When evaluating only major trauma (ISS >16), IR performed a procedure on 20.4% patients (59/289) of the overall major trauma cohort, 24.2% penetrating (23/95), and 18.6% blunt (36/194). IR performed a total of 167 procedures during 161 encounters for all trauma activations (75/167 penetrating, 44.9%; 92/167 blunt 55.1%). Of the procedures performed, 126/167 (75.4%) were directly related to the presenting trauma (penetrating: 63/75, 84%; blunt: 63/92, 68.5%). The most common procedure performed was angiography (+/- embolization) with 58/167 procedures (34.7%) followed by drainages with 57/167 (34.1%). For all trauma patients that underwent angiography, 44/58 required embolization (75.7%) with similar rates for penetrating (16/21, 76.2%) and blunt (28/37, 75.7%). Intervention within the first 24 hours was the most common time point (57/161 procedural encounters, 35.4%). When stratifying by both the type of procedure and when it occurred after time of presentation, we found that 41/62 procedures (66.1%) that occurred during the first 24 hours were angiography procedures, highlighting the critical role of IR in early treatment of trauma patients. When breaking down further into penetrating vs blunt, this remained the same.

Conclusion: Interventional radiology plays a critical and quantifiable role in the acute care of patients after trauma activation. A robust IR division at any level I trauma center is crucial for rapid, life-saving care of patients with major trauma, especially those with bleeding.