Management of spleen injuries: the current profile

Mikocka-Walus, Antonina, Beevor, Harriet C., Gabbe, Belinda, Gruen, Russell L., Winnett, Jason and Cameron, Peter 2010, Management of spleen injuries: the current profile, ANZ journal of surgery, vol. 80, no. 3, pp. 157-161, doi: 10.1111/j.1445-2197.2010.05209.x.

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Title Management of spleen injuries: the current profile
Author(s) Mikocka-Walus, AntoninaORCID iD for Mikocka-Walus, Antonina
Beevor, Harriet C.
Gabbe, Belinda
Gruen, Russell L.
Winnett, Jason
Cameron, Peter
Journal name ANZ journal of surgery
Volume number 80
Issue number 3
Start page 157
End page 161
Total pages 5
Publisher Wiley-Blackwell Publishing Asia
Place of publication Milton, Qld.
Publication date 2010-03
ISSN 1445-1433
Keyword(s) conservative management
epidemiology of splenic injuries
Summary BACKGROUND: There has been a shift from operative to conservative management of splenic injuries in the last two decades, but the current practice in Australia is not known. This study aims to determine the profile of splenic injury in major trauma victims and the approach to treatment in Victoria for the last 2 years.

METHODS: A review of prospectively collected data from the Victorian State Trauma Registry (VSTR) from July 2005 to June 2007 was conducted. Demographic data, details of the event, clinical observations, management and associated outcomes were extracted from the database. The patients were categorized into four groups according to management (conservative, splenectomy, embolization and repair) and were compared accordingly. Multivariate binary logistic regression was performed to identify predictors of treatment (conservative versus splenectomy) on arrival.

RESULTS: Of the 318 major trauma patients with splenic injuries, 186 (59%) were treated conservatively, 103 (32%) with splenectomy, 17 (5%) with arterial embolization and 12 (4%) with repair. Of these, 14 (14%) splenectomy cases and 2 (12%) embolization cases did not receive their respective treatments within 24 h. The severity of the spleen injury (as measured by the Abbreviated Injury Scale (AIS)) and age were identified as significant independent predictors of the form of treatment provided.

CONCLUSION: In Victoria, conservative management is the preferred approach in patients with minor (AIS = 2) to moderate (AIS = 3) splenic injuries. The low rates of embolization warrant further research into whether splenectomy is overused.
Language eng
DOI 10.1111/j.1445-2197.2010.05209.x
Field of Research 111716 Preventive Medicine
111706 Epidemiology
110305 Emergency Medicine
1103 Clinical Sciences
Socio Economic Objective 920412 Preventive Medicine
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2010, The Authors
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Document type: Journal Article
Collections: Faculty of Health
School of Psychology
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