Age over 40 years increases the failure rate of non-operative management of blunt splenic injuries
Details
Serval ID
serval:BIB_6596DC45282C
Type
Inproceedings: an article in a conference proceedings.
Publication sub-type
Abstract (Abstract): shot summary in a article that contain essentials elements presented during a scientific conference, lecture or from a poster.
Collection
Publications
Institution
Title
Age over 40 years increases the failure rate of non-operative management of blunt splenic injuries
Title of the conference
97th Annual Congress of the Swiss Society of Surgery
Address
Interlaken, Switzerland, May 26-28, 2010
ISBN
1365-2168
Publication state
Published
Issued date
2010
Volume
97
Series
British Journal of Surgery
Pages
10
Language
english
Abstract
Objective: Non-operative management (NOM) of blunt splenic injuries (BSI)
is nowadays considered the standard treatment. The study aimed to determine
the criteria applied for NOM and to identify risk factors for its failure.
Methods: Review of all adult patients with BSI treated at the University
Hospital Bern, Switzerland, between 2000 and 2008.
Results: There were 206 patients (146 men, 70·9%) with a mean age of
38·2 ± 19·1 years and an Injury Severity Score of 30·9 ± 11·6. The American
Association for the Surgery of Trauma classification of the splenic injury was:
grade I, n=43 (20·9%); grade II, n=52 (25·2%); grade III, n=60 (29·1%); grade
IV, n=42 (20·4%) and grade V, n=9 (4·4%). 47 patients (22·8%) required
immediate surgery. Five or more units of red cell transfusions (P<0·001),
Glasgow Coma Scale<11 (P=0·009) and age ≥55 years (P=0·038) were
associated with primary operative management (OM). 159 patients (77·2%)
qualified for NOM, which was successful in 89·9% (143/159). The overall
splenic salvage rate was 69·4% (143/206). Multivariate analysis found age
≥40 years to be the only factor independently related to the failure of NOM
(P=0·001).
Conclusion: Advanced age is associated with an increased failure rate ofNOM
in patients with BSI.
is nowadays considered the standard treatment. The study aimed to determine
the criteria applied for NOM and to identify risk factors for its failure.
Methods: Review of all adult patients with BSI treated at the University
Hospital Bern, Switzerland, between 2000 and 2008.
Results: There were 206 patients (146 men, 70·9%) with a mean age of
38·2 ± 19·1 years and an Injury Severity Score of 30·9 ± 11·6. The American
Association for the Surgery of Trauma classification of the splenic injury was:
grade I, n=43 (20·9%); grade II, n=52 (25·2%); grade III, n=60 (29·1%); grade
IV, n=42 (20·4%) and grade V, n=9 (4·4%). 47 patients (22·8%) required
immediate surgery. Five or more units of red cell transfusions (P<0·001),
Glasgow Coma Scale<11 (P=0·009) and age ≥55 years (P=0·038) were
associated with primary operative management (OM). 159 patients (77·2%)
qualified for NOM, which was successful in 89·9% (143/159). The overall
splenic salvage rate was 69·4% (143/206). Multivariate analysis found age
≥40 years to be the only factor independently related to the failure of NOM
(P=0·001).
Conclusion: Advanced age is associated with an increased failure rate ofNOM
in patients with BSI.
Open Access
Yes
Create date
02/02/2011 11:47
Last modification date
20/08/2019 15:21
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