Citation

Jeremitsky E, Smith RS, Ong AW. Am. J. Surg. 2013; 205(3): 298-301.

Affiliation

Department of Trauma, Allegheny General Hospital, 320 East North Avenue, Pittsburgh, PA 15212, USA. jeremitskye@yahoo.com

Copyright

(Copyright © 2013, Elsevier Publishing)

DOI

10.1016/j.amjsurg.2012.10.022

PMID

23351507

Abstract

BACKGROUND: There is no consensus when the designation of nonoperative management (NOM) for splenic injury (BSI) should start. We evaluated NOM success rates based on different time points after admission.

METHODS: The National Trauma Data Bank was evaluated for BSI for the year 2008. Observations were evaluated by facility, the time to splenectomy, and the volume of BSI admissions.

RESULTS: Of 15,732 BSIs identified, the overall splenectomy salvage rate was 81%. After the 5th hour, the NOM success rate was 95%. Multivariable analysis revealed that higher BSI grades, level 2 centers and community hospitals, and age ≥55 were associated with failed NOM.

CONCLUSIONS: The grade of injury is an important predictor for failure of NOM. If a 5% failure rate is to be considered a benchmark, then the 5-hour time point after admission should be used for the calculation of NOM success rates.

Language: en