To the Editor We read with great interest the article by Joseph et al.¹ This is a 420-patient case-control study with propensity score matching that examines the value of resuscitative endovascular balloon occlusion of the aorta (REBOA). Patients undergoing REBOA were found to have worse outcomes than matched controls. However, the use of causal language surrounding the findings of the article—that REBOA use increases mortality risk—is unsupported. We posit that at least 2 biases regarding hospital confounding and time to surgery and selection bias for survivors draw this conclusion into question.

中文翻译：

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解决病例对照研究中接受复苏性主动脉腔内血管球囊阻塞的患者的局限性。

致编辑我们非常感兴趣地阅读了约瑟夫等人的文章。¹这是一项420名患者的病例对照研究，具有倾向评分匹配，研究了可复苏的主动脉腔内血管球囊闭塞（REBOA）的价值。发现接受REBOA的患者比匹配的对照者的结局更差。但是，围绕因果关系使用因果语言（使用REBOA会增加死亡风险）不受支持。我们认为，至少有2个关于医院混淆和手术时间的偏见以及幸存者的选择偏见使这一结论受到质疑。