Resuscitative endovascular balloon occlusion
of the aorta in abdominal trauma: zone-
specific outcomes and predictors of mortality
Dublin Core
Title
Resuscitative endovascular balloon occlusion
of the aorta in abdominal trauma: zone-
specific outcomes and predictors of mortality
of the aorta in abdominal trauma: zone-
specific outcomes and predictors of mortality
Subject
REBOA, Abdominal trauma, Hemorrhage control, Aortic occlusion, Trauma resuscitation, Endovascular
techniques
techniques
Description
Abstract
Background Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is increasingly utilized for
hemorrhage control in trauma; however, zone-specific outcomes in abdominal trauma remain inadequately
characterized.
Methods We retrospectively analyzed 404 patients with abdominal trauma who underwent REBOA between 2019
and 2022. Patients were stratified by aortic occlusion zone (zones 1, 2, or 3), and their demographic characteristics,
injury patterns, resuscitation requirements, and clinical outcomes were compared.
Results The cohort was predominantly male (83.8%), with a median age of 35.0 years. The distribution of the
zones was as follows: Zone 1 (33.7%); Zone 2 (4.7%); and Zone 3 (61.6%). Patients in Zone 1 presented with more
severe hemodynamic compromise (median SBP 77.0 mmHg vs. 107.0 mmHg in Zone 2 and 103.0 mmHg in Zone
3, P<0.001) and lower GCS scores (median 6.0 vs. 15.0 in both Zones 2 and 3, P<0.001). Mortality was significantly
higher in Zone 1 (73.6%) than in Zones 2 (27.8%) and 3 (37.7%) (P<0.001). Multivariate analysis identified GCS score
(OR 0.80 per point increase, 95% CI 0.73–0.87, P<0.001) and Zone 3 placement (OR 0.20 vs. Zone 1, 95% CI 0.08–0.47,
P<0.001) as independent predictors of survival. Overall mortality decreased from 58% in 2019 to 36% in 2022, despite
the increased utilization of REBOA.
Conclusion REBOA zone placement and neurological status are powerful independent predictors of mortality in
patients with abdominal trauma. These findings support a zone-specific approach to REBOA deployment in patients
with abdominal trauma.
Keywords REBOA, Abdominal trauma, Hemorrhage control, Aortic occlusion, Trauma resuscitation, Endovascular
techniques
Background Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) is increasingly utilized for
hemorrhage control in trauma; however, zone-specific outcomes in abdominal trauma remain inadequately
characterized.
Methods We retrospectively analyzed 404 patients with abdominal trauma who underwent REBOA between 2019
and 2022. Patients were stratified by aortic occlusion zone (zones 1, 2, or 3), and their demographic characteristics,
injury patterns, resuscitation requirements, and clinical outcomes were compared.
Results The cohort was predominantly male (83.8%), with a median age of 35.0 years. The distribution of the
zones was as follows: Zone 1 (33.7%); Zone 2 (4.7%); and Zone 3 (61.6%). Patients in Zone 1 presented with more
severe hemodynamic compromise (median SBP 77.0 mmHg vs. 107.0 mmHg in Zone 2 and 103.0 mmHg in Zone
3, P<0.001) and lower GCS scores (median 6.0 vs. 15.0 in both Zones 2 and 3, P<0.001). Mortality was significantly
higher in Zone 1 (73.6%) than in Zones 2 (27.8%) and 3 (37.7%) (P<0.001). Multivariate analysis identified GCS score
(OR 0.80 per point increase, 95% CI 0.73–0.87, P<0.001) and Zone 3 placement (OR 0.20 vs. Zone 1, 95% CI 0.08–0.47,
P<0.001) as independent predictors of survival. Overall mortality decreased from 58% in 2019 to 36% in 2022, despite
the increased utilization of REBOA.
Conclusion REBOA zone placement and neurological status are powerful independent predictors of mortality in
patients with abdominal trauma. These findings support a zone-specific approach to REBOA deployment in patients
with abdominal trauma.
Keywords REBOA, Abdominal trauma, Hemorrhage control, Aortic occlusion, Trauma resuscitation, Endovascular
techniques
Creator
Musaed Rayzah1* , Nasser A. N. Alzerwi1
, Bandar Idrees2
, Ahmed A. Alhumaid3
, Yaser Baksh4
and Fares Rayzah5
, Bandar Idrees2
, Ahmed A. Alhumaid3
, Yaser Baksh4
and Fares Rayzah5
Source
https://doi.org/10.1186/s12245-025-01117-6
Date
2026
Contributor
peri irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Musaed Rayzah1* , Nasser A. N. Alzerwi1
, Bandar Idrees2
, Ahmed A. Alhumaid3
, Yaser Baksh4
and Fares Rayzah5, “Resuscitative endovascular balloon occlusion
of the aorta in abdominal trauma: zone-
specific outcomes and predictors of mortality,” Repository Horizon University Indonesia, accessed April 27, 2026, https://repository.horizon.ac.id/items/show/12970.
of the aorta in abdominal trauma: zone-
specific outcomes and predictors of mortality,” Repository Horizon University Indonesia, accessed April 27, 2026, https://repository.horizon.ac.id/items/show/12970.