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Management of spleen injuries: the current profile

Version 2 2024-06-04, 09:31
Version 1 2016-12-05, 15:44
journal contribution
posted on 2024-06-04, 09:31 authored by Antonina Mikocka-WalusAntonina Mikocka-Walus, HC Beevor, B Gabbe, RL Gruen, J Winnett, P Cameron
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.

History

Journal

ANZ journal of surgery

Volume

80

Pagination

157-161

Location

Milton, Qld.

ISSN

1445-1433

eISSN

1445-2197

Language

eng

Publication classification

C Journal article, C1.1 Refereed article in a scholarly journal

Copyright notice

2010, The Authors

Issue

3

Publisher

Wiley-Blackwell Publishing Asia