Changing trends in the management of splenic injury

Changing trends in the management of splenic injury

Background: A gradual change in the management of splenic injuries has occurred at our institution. This study was therefore undertaken to determine whether changes in management of splenic injury influenced outcomes during the past 30 years. Patients and methods: A retrospective study of patients a...

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Bibliographic Details
Published in:The American journal of surgery Vol. 170; no. 6; pp. 686 - 690
Main Authors: Morrell, David G., Chang, Frederic C., Helmer, Stephen D.
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01-12-1995
Elsevier Limited
Subjects:
Adult
Blood Transfusion
Female
Humans
Injuries
Length of Stay
Male
Patients
Retrospective Studies
Spleen
Spleen - injuries
Spleen - surgery
Splenectomy
Treatment Outcome
Wounds and Injuries - diagnosis
Wounds and Injuries - surgery
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Summary:Background: A gradual change in the management of splenic injuries has occurred at our institution. This study was therefore undertaken to determine whether changes in management of splenic injury influenced outcomes during the past 30 years. Patients and methods: A retrospective study of patients admitted with splenic trauma between 1965 and 1994 was performed. Two hundred seven patients were identified and demographic and outcome data were recorded. Patients were then grouped based upon the period in which they received treatment (ie, Period I [1965 to 1974], Period II [1975 to 1984], and Period III [1985 to 1994]) and the type of treatment received (ie, splenectomy, splenorrhaphy, or observation). Results: More patients were treated in Period III than in the other two periods, and Period III patients had shorter hospital stays. Splenectomy was solely used during Period I; splenorrhaphy and observation were occasionally performed during Period II; and splenectomy, splenorrhaphy, and observation were performed in near-equal numbers during Period III. Mortality was similar for each period, though Injury Severity Scores (ISS) were higher during later years. When compared by treatment modality, patients receiving splenectomy had higher ISS and splenic injury classifications. Conclusion: Patients treated by splenorrhaphy and observation for splenic injury have markedly increased over the past 30 years without adverse outcome.
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ISSN:0002-9610
1879-1883
DOI:10.1016/S0002-9610(99)80042-7