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European Journal of Trauma and Emergency Surgery

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Open Access 18-11-2020 | Central Nervous System Trauma | Original Article

Traumatic brain injury with concomitant injury to the spleen: characteristics and mortality of a high-risk trauma cohort from the TraumaRegister DGU®

Authors: Marius Marc-Daniel Mader, Rolf Lefering, Manfred Westphal, Marc Maegele, Patrick Czorlich

Published in: European Journal of Trauma and Emergency Surgery | Issue 6/2022

Abstract

Purpose

Based on the hypothesis that systemic inflammation contributes to secondary injury after initial traumatic brain injury (TBI), this study aims to describe the effect of splenectomy on mortality in trauma patients with TBI and splenic injury.

Methods

A retrospective cohort analysis of patients prospectively registered into the TraumaRegister DGU^® (TR-DGU) with TBI (AIS_Head ≥ 3) combined with injury to the spleen (AIS_Spleen ≥ 1) was conducted. Multivariable logistic regression modeling was performed to adjust for confounding factors and to assess the independent effect of splenectomy on in-hospital mortality.

Results

The cohort consisted of 1114 patients out of which 328 (29.4%) had undergone early splenectomy. Patients with splenectomy demonstrated a higher Injury Severity Score (median: 34 vs. 44, p < 0.001) and lower Glasgow Coma Scale (median: 9 vs. 7, p = 0.014) upon admission. Splenectomized patients were more frequently hypotensive upon admission (19.8% vs. 38.0%, p < 0.001) and in need for blood transfusion (30.3% vs. 61.0%, p < 0.001). The mortality was 20.7% in the splenectomy group and 10.3% in the remaining cohort. After adjustment for confounding factors, early splenectomy was not found to exert a significant effect on in-hospital mortality (OR 1.29 (0.67–2.50), p = 0.45).

Conclusion

Trauma patients with TBI and spleen injury undergoing splenectomy demonstrate a more severe injury pattern, more compromised hemodynamic status and higher in-hospital mortality than patients without splenectomy. Adjustment for confounding factors reveals that the splenectomy procedure itself is not independently associated with survival.

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Title: Traumatic brain injury with concomitant injury to the spleen: characteristics and mortality of a high-risk trauma cohort from the TraumaRegister DGU®
Authors: Marius Marc-Daniel Mader
Rolf Lefering
Manfred Westphal
Marc Maegele
Patrick Czorlich
Publication date: 18-11-2020
Publisher: Springer Berlin Heidelberg
Keywords: Central Nervous System Trauma
Splenectomy
Splenectomy
Published in: European Journal of Trauma and Emergency Surgery / Issue 6/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-020-01544-5

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Traumatic brain injury with concomitant injury to the spleen: characteristics and mortality of a high-risk trauma cohort from the TraumaRegister DGU®

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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