Journal article
Nonoperative management of splenic injuries: significance of age
The Journal of surgical research, v 201(1), pp 134-140
01 Mar 2016
PMID: 26850194
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
In the nonoperative management (NOM) of blunt splenic injuries (BSI), the clinical relevance of age as a risk factor has not been well studied.
Using the 2011 National Trauma Data Bank data set, age was analyzed both as a continuous variable and a categorical variable (group 1 [13-54 y], group 2 [55-74 y], and group 3 [≥75 y]). BSI severity was stratified by abbreviated injury scale (AIS): group 1 (AIS ≤2), group 2 (AIS 3), and group 3 (AIS ≥4). A semiparametric proportional odds model was used to model NOM outcomes and effects due to age and BSI severity.
Of 15,113 subjects, 15.3% failed NOM. The odds of failure increased by a factor of 1.014 for each year of age, or factor of 1.5 for groups 2 and 3 each. BSI severity groups 2 and 3 had increases in the odds of failure by factors of 3.9 and 13, respectively, compared with those of group 1. Most failures occurred by 48 h irrespective of age. The effect of age was most pronounced in age groups 2 and 3 with the most severe BSI, where a NOM failure rate of >50% was seen. Both age and failure of NOM were independent predictors of mortality.
Age is associated with failure of NOM but its effect seems more clinically relevant only in high-grade BSI. Factors that could influence NOM success in elderly patients with high-grade injuries deserve further study.
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Details
- Title
- Nonoperative management of splenic injuries: significance of age
- Creators
- Adrian W Ong - Reading HospitalKirsten E Eilertson - Pennsylvania State UniversityEugene F Reilly - Reading HospitalThomas A Geng - Reading HospitalFiras Madbak - Reading HospitalAmanda McNicholas - Reading HospitalForrest B Fernandez - Reading Hospital
- Publication Details
- The Journal of surgical research, v 201(1), pp 134-140
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:000369599200017
- Scopus ID
- 2-s2.0-84958279490
- Other Identifier
- 991022020737504721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Surgery