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European Journal of Trauma and Emergency Surgery

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Open Access 01-02-2022 | Original Article

Increased hospital treatment volume of splenic injury predicts higher rates of successful non-operative management and reduces hospital length of stay: a Swiss Trauma Registry analysis

Authors: Joël L. Lavanchy, Luciane Delafontaine, Tobias Haltmeier, Piotr Bednarski, Beat Schnüriger, the Swiss Trauma Registry

Published in: European Journal of Trauma and Emergency Surgery | Issue 1/2022

Abstract

Purpose

First time analysis of the epidemiology, management and outcomes of patients with splenic injuries in Switzerland. This study aims to assess the effect of hospital treatment volume on successful non-operative management (NOM) in splenic injuries.

Methods

A multicentric registry-based study including all patients with splenic injuries entered into the Swiss Trauma Registry from 2015 to 2018 was conducted. Patients were stratified according to the hospitals treatment volume of splenic injuries. Primary outcome was the rate of successful NOM.

Results

During the 4-year study period, 652 patients with splenic injury were included in the study. Median age of the study population was 42 (IQR 27–59) years, and median ISS was 26 (20–34). The overall rate of successful NOM was 86.5%. Median HLOS was 13 (8–21) days. In-hospital mortality was 7.2% (n = 47). The mean number of patients with splenic injuries per center and year was 14. Five out of 12 Level I trauma centers treating more patients than the mean (≥ 15/year) were defined as high-volume centers.

Multivariable analysis adjusting for differences in baseline and injury characteristics revealed treatment in a high-volume center as an independent predictor for successful NOM (OR 2.15, 95% CI 1.28–3.60, p = 0.004) and shorter HLOS (RC − 2.39, 95% CI − 4.91/− 0.48, p = 0.017), however, not for reduced in-hospital mortality (OR 0.92, 95% CI 0.39–2.18, p = 0.845).

Conclusion

Higher hospital treatment volume was associated with a higher rate of NOM and shorter HLOS, but not lower mortality. These results constitute the basis for further quality improvement in the care of splenic injury patients within the trauma system in Switzerland.

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Title: Increased hospital treatment volume of splenic injury predicts higher rates of successful non-operative management and reduces hospital length of stay: a Swiss Trauma Registry analysis
Authors: Joël L. Lavanchy
Luciane Delafontaine
Tobias Haltmeier
Piotr Bednarski
Beat Schnüriger
the Swiss Trauma Registry
Publication date: 01-02-2022
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Trauma and Emergency Surgery / Issue 1/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-020-01582-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Increased hospital treatment volume of splenic injury predicts higher rates of successful non-operative management and reduces hospital length of stay: a Swiss Trauma Registry analysis

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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