Journal article
Failure rates of nonoperative management of low-grade splenic injuries with active extravasation: an Eastern Association for the Surgery of Trauma multicenter study
Trauma surgery & acute care open, Vol.9(1), e001159
01 Mar 2024
PMID: 38464553
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
ObjectivesThere is little evidence guiding the management of grade I–II traumatic splenic injuries with contrast blush (CB). We aimed to analyze the failure rate of nonoperative management (NOM) of grade I–II splenic injuries with CB in hemodynamically stable patients.MethodsA multicenter, retrospective cohort study examining all grade I–II splenic injuries with CB was performed at 21 institutions from January 1, 2014, to October 31, 2019. Patients >18 years old with grade I or II splenic injury due to blunt trauma with CB on CT were included. The primary outcome was the failure of NOM requiring angioembolization/operation. We determined the failure rate of NOM for grade I versus grade II splenic injuries. We then performed bivariate comparisons of patients who failed NOM with those who did not.ResultsA total of 145 patients were included. Median Injury Severity Score was 17. The combined rate of failure for grade I–II injuries was 20.0%. There was no statistical difference in failure of NOM between grade I and II injuries with CB (18.2% vs 21.1%, p>0.05). Patients who failed NOM had an increased median hospital length of stay (p=0.024) and increased need for blood transfusion (p=0.004) and massive transfusion (p=0.030). Five patients (3.4%) died and 96 (66.2%) were discharged home, with no differences between those who failed and those who did not fail NOM (both p>0.05).ConclusionNOM of grade I–II splenic injuries with CB fails in 20% of patients.Level of evidenceIV.
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Details
- Title
- Failure rates of nonoperative management of low-grade splenic injuries with active extravasation: an Eastern Association for the Surgery of Trauma multicenter study
- Creators
- Kristen Spoor - Prisma HealthJohn David Cull - Prisma HealthBanan W Otaibi - Pennsylvania State UniversityJoshua P Hazelton - Pennsylvania State UniversityJohn Chipko - Research Medical CenterJessica Reynolds - University of KentuckySam Fugate - University of Kentucky HealthCareClaire Pederson - Medical Center of the Rockies, Loveland, Colorado, USALinda B Zier - Medical Center of the Rockies, Loveland, Colorado, USALewis E Jacobson - St Vincent HospitalJamie M Williams - St Vincent HospitalThomas S Easterday - University of Tennessee Health Science CenterSaskya Byerly - University of Tennessee Health Science CenterCaleb Mentzer - The University of Texas Health Science Center at HoustonEdward Hawke - Spartanburg Regional Healthcare SystemDaniel C Cullinane - Maine Medical CenterJulianne B Ontengco - Maine Medical CenterNikolay Bugaev - Tufts Medical CenterMadison LeClair - Tufts Medical CenterPascal Udekwu - WakeMedCooper Josephs - WakeMedMatthew Noorbaksh - Allegheny General HospitalJames Babowice - Allegheny Health NetworkCatherine Garrison Velopulos - University of Colorado DenverShane Urban - University of Colorado Anschutz Medical CampusAnna Goldenberg - Cooper University HospitalGaby Ghobrial - Cooper University HospitalJohn M Pickering - Erlanger Health SystemSteven D Quarfordt - Erlanger Health SystemAlia F Aunchman - University of Vermont Medical CenterAimee K LaRiccia - University of Vermont Medical CenterChance Spalding - Grant Medical CenterRichard D Catalano - Loma Linda UniversityJordan E Basham - Loma Linda UniversityPhilip M Edmundson - Texas Health DallasJeffry Nahmias - Texas Health DallasErika Tay - Texas Health DallasScott H Norwood - The University of Texas Health Science Center at TylerKatelyn Meadows - The University of Texas Health Science Center at TylerYee Wong - HealthPartnersClaire Hardman - Wright State Physicians, Department of Surgery, Dayton, Ohio, USA
- Publication Details
- Trauma surgery & acute care open, Vol.9(1), e001159
- Publisher
- BMJ Publishing Group Ltd
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:001181286200008
- Scopus ID
- 2-s2.0-85187538591
- Other Identifier
- 991022057016604721
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- Web of Science research areas
- Critical Care Medicine
- Surgery