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European Journal of Trauma and Emergency Surgery

Published in:

01-06-2012 | Original Article

Splenic injuries: factors affecting the outcome of non-operative management

Authors: A. Böyük, M. Gümüş, A. Önder, M. Kapan, İ. Aliosmanoğlu, F. Taşkesen, Z. Arıkanoğlu, E. Gedik

Published in: European Journal of Trauma and Emergency Surgery | Issue 3/2012

Abstract

Purpose

The aim of this study was to evaluate the outcome of non-operative management (NOM) in patients with splenic injuries and to determine the predictive factors of NOM failure.

Methods

Two hundred and six patients with splenic injury were admitted between January 2005 and April 2011. Of the 206 patients with splenic injury, 47 patients met the inclusion criteria of NOM. The mechanism of injury, grade of splenic injury, other intra- and extra-abdominal injuries, systolic blood pressure on admission, hemoglobin levels, number of transfusions, Injury Severity Score (ISS), Glasgow Coma Scale score, and hospitalization period were recorded. The patients were divided into two groups: those with NOM and those in whom the failure of NOM led to laparotomy. The patients were monitored for vital signs, abdominal findings, and laboratory data. NOM was abandoned in cases of hemodynamic instability, ongoing bleeding, or development of peritonitis. Independent predictive factors of NOM failure were identified. The patients managed non-operatively were compared with the patients for whom NOM failed.

Results

NOM was successful in 40 of 47 patients. There were differences between the two groups for ISS, hemoglobin levels, need for blood transfusion, and the number of associated extra-abdominal injuries. The grade of splenic injury was determined to be an important and significant independent predictive factor for the success of NOM of splenic injuries.

Conclusions

The grade of splenic injury is an important and significant independent predictor factor for the success of NOM. NOM is not recommended in patients with high-grade splenic injury.

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Title: Splenic injuries: factors affecting the outcome of non-operative management
Authors: A. Böyük
M. Gümüş
A. Önder
M. Kapan
İ. Aliosmanoğlu
F. Taşkesen
Z. Arıkanoğlu
E. Gedik
Publication date: 01-06-2012
Publisher: Springer-Verlag
Published in: European Journal of Trauma and Emergency Surgery / Issue 3/2012
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-011-0156-8

At a glance: The STEP trials

Springer Medicine

Splenic injuries: factors affecting the outcome of non-operative management

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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