Advanced age increases the failure rate of non-operative management of blunt splenic injuries
Détails
ID Serval
serval:BIB_A6A06CAEA851
Type
Actes de conférence (partie): contribution originale à la littérature scientifique, publiée à l'occasion de conférences scientifiques, dans un ouvrage de compte-rendu (proceedings), ou dans l'édition spéciale d'un journal reconnu (conference proceedings).
Sous-type
Abstract (résumé de présentation): article court qui reprend les éléments essentiels présentés à l'occasion d'une conférence scientifique dans un poster ou lors d'une intervention orale.
Collection
Publications
Institution
Titre
Advanced age increases the failure rate of non-operative management of blunt splenic injuries
Titre de la conférence
11th European Congress of Trauma and Emergency Surgery
Adresse
Brussels. Belgium, May 15-18, 2010
ISBN
1863-9941
Statut éditorial
Publié
Date de publication
2010
Volume
36
Série
European Journal of Trauma and Emergency Surgery
Pages
66
Langue
anglais
Résumé
Introduction: Non-operative management (NOM) of blunt splenic
injuries in hemodynamically stable patients is nowadays considered
the standard treatment.
Material and Methods: The aim was to clarify the criteria used for
primary operative management (OM) and planned NOM. Furthermore,
the study aimed to identify risk factors for failure of NOM. All
adult patients with blunt splenic injuries treated from 2000-2008 were
reviewed and a logistic regression analysis employed.
Results: There were 206 patients (146 men, 70.9%). Mean age was
38.2 ± 19.1 years. The mean Injury Severity Score (ISS) was
30.9 ± 11.6. The American Association for the Surgery of Trauma
(AAST) 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 (OM). More than 5 units of red cell
transfusions (odds ratio [OR] 13.72, P < 0.001), a Glasgow Coma
Scale < 11 (OR 9.88, P = 0.009) and age ? 55 years (OR 3.29,
P = 0.038) were associated with primary OM. 159 patients (77.2%)
qualified for a non-surgical approach (NOM), which was successful in
89.9% (143/159). The overall splenic salvage rate amounted to 69.4%
(143/206). Multiple logistic regression analysis found age ? 40 years
to be the only factor significantly and independently related to the
failure of NOM (OR 13.58, P = 0.001).
Conclusion: Advanced age is associated with an increased failure rate
of NOM in patients with blunt splenic injuries.
injuries in hemodynamically stable patients is nowadays considered
the standard treatment.
Material and Methods: The aim was to clarify the criteria used for
primary operative management (OM) and planned NOM. Furthermore,
the study aimed to identify risk factors for failure of NOM. All
adult patients with blunt splenic injuries treated from 2000-2008 were
reviewed and a logistic regression analysis employed.
Results: There were 206 patients (146 men, 70.9%). Mean age was
38.2 ± 19.1 years. The mean Injury Severity Score (ISS) was
30.9 ± 11.6. The American Association for the Surgery of Trauma
(AAST) 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 (OM). More than 5 units of red cell
transfusions (odds ratio [OR] 13.72, P < 0.001), a Glasgow Coma
Scale < 11 (OR 9.88, P = 0.009) and age ? 55 years (OR 3.29,
P = 0.038) were associated with primary OM. 159 patients (77.2%)
qualified for a non-surgical approach (NOM), which was successful in
89.9% (143/159). The overall splenic salvage rate amounted to 69.4%
(143/206). Multiple logistic regression analysis found age ? 40 years
to be the only factor significantly and independently related to the
failure of NOM (OR 13.58, P = 0.001).
Conclusion: Advanced age is associated with an increased failure rate
of NOM in patients with blunt splenic injuries.
Création de la notice
02/02/2011 15:16
Dernière modification de la notice
20/08/2019 16:11
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