BACKGROUND: The postdischarge natural history of nonoperative blunt splenic injury (BSI) has not been adequately elucidated. As a result, outpatient management is poorly defined. Population-based outpatient data would provide clinicians with an estimate of baseline risk of postdischarge splenectomy after nonoperative management of BSI. The purpose of this study was to analyze, using population-based data, the 180-day risk of splenectomy in a clinically relevant sample. METHODS: A statewide Hospital Discharge Data System containing patient level data was used to construct a prospective cohort of persons 18 or older with nonoperatively managed BSI admitted to any hospital in the state from 2000 to 2005 and discharged home. Re-admission for splenectomy within 180 days from the original injury date was analyzed. RESULTS: Four thousand one hundred three persons with BSI were admitted from 2000 to 2005. Two thousand nine hundred seventy-one (72.4%) were managed nonoperatively. One thousand nine hundred thirty-two (47.1%) were discharged. Twenty-seven of 1,932 were re-admitted for splenectomy within 180 days. Median time from injury to re-admission for splenectomy was 8 days (range, 3-146). The 180-day risk of splenectomy was 1.4% after nonoperative management and discharge home. CONCLUSIONS: Nonoperative management of BSI results in a 180-day risk of re-admission for splenectomy of 1.4% for persons discharged home. A majority of splenectomies occur within 8 days. Explicit patient education and close follow-up are necessary.
BACKGROUND: The postdischarge natural history of nonoperative blunt splenic injury (BSI) has not been adequately elucidated. As a result, outpatient management is poorly defined. Population-based outpatient data would provide clinicians with an estimate of baseline risk of postdischarge splenectomy after nonoperative management of BSI. The purpose of this study was to analyze, using population-based data, the 180-day risk of splenectomy in a clinically relevant sample. METHODS: A statewide Hospital Discharge Data System containing patient level data was used to construct a prospective cohort of persons 18 or older with nonoperatively managed BSI admitted to any hospital in the state from 2000 to 2005 and discharged home. Re-admission for splenectomy within 180 days from the original injury date was analyzed. RESULTS: Four thousand one hundred three persons with BSI were admitted from 2000 to 2005. Two thousand nine hundred seventy-one (72.4%) were managed nonoperatively. One thousand nine hundred thirty-two (47.1%) were discharged. Twenty-seven of 1,932 were re-admitted for splenectomy within 180 days. Median time from injury to re-admission for splenectomy was 8 days (range, 3-146). The 180-day risk of splenectomy was 1.4% after nonoperative management and discharge home. CONCLUSIONS: Nonoperative management of BSI results in a 180-day risk of re-admission for splenectomy of 1.4% for persons discharged home. A majority of splenectomies occur within 8 days. Explicit patient education and close follow-up are necessary.
Authors: Mauro Podda; Belinda De Simone; Marco Ceresoli; Francesco Virdis; Francesco Favi; Johannes Wiik Larsen; Federico Coccolini; Massimo Sartelli; Nikolaos Pararas; Solomon Gurmu Beka; Luigi Bonavina; Raffaele Bova; Adolfo Pisanu; Fikri Abu-Zidan; Zsolt Balogh; Osvaldo Chiara; Imtiaz Wani; Philip Stahel; Salomone Di Saverio; Thomas Scalea; Kjetil Soreide; Boris Sakakushev; Francesco Amico; Costanza Martino; Andreas Hecker; Nicola de'Angelis; Mircea Chirica; Joseph Galante; Andrew Kirkpatrick; Emmanouil Pikoulis; Yoram Kluger; Denis Bensard; Luca Ansaloni; Gustavo Fraga; Ian Civil; Giovanni Domenico Tebala; Isidoro Di Carlo; Yunfeng Cui; Raul Coimbra; Vanni Agnoletti; Ibrahima Sall; Edward Tan; Edoardo Picetti; Andrey Litvin; Dimitrios Damaskos; Kenji Inaba; Jeffrey Leung; Ronald Maier; Walt Biffl; Ari Leppaniemi; Ernest Moore; Kurinchi Gurusamy; Fausto Catena Journal: World J Emerg Surg Date: 2022-10-12 Impact factor: 8.165
Authors: Federico Coccolini; Giulia Montori; Fausto Catena; Yoram Kluger; Walter Biffl; Ernest E Moore; Viktor Reva; Camilla Bing; Miklosh Bala; Paola Fugazzola; Hany Bahouth; Ingo Marzi; George Velmahos; Rao Ivatury; Kjetil Soreide; Tal Horer; Richard Ten Broek; Bruno M Pereira; Gustavo P Fraga; Kenji Inaba; Joseph Kashuk; Neil Parry; Peter T Masiakos; Konstantinos S Mylonas; Andrew Kirkpatrick; Fikri Abu-Zidan; Carlos Augusto Gomes; Simone Vasilij Benatti; Noel Naidoo; Francesco Salvetti; Stefano Maccatrozzo; Vanni Agnoletti; Emiliano Gamberini; Leonardo Solaini; Antonio Costanzo; Andrea Celotti; Matteo Tomasoni; Vladimir Khokha; Catherine Arvieux; Lena Napolitano; Lauri Handolin; Michele Pisano; Stefano Magnone; David A Spain; Marc de Moya; Kimberly A Davis; Nicola De Angelis; Ari Leppaniemi; Paula Ferrada; Rifat Latifi; David Costa Navarro; Yashuiro Otomo; Raul Coimbra; Ronald V Maier; Frederick Moore; Sandro Rizoli; Boris Sakakushev; Joseph M Galante; Osvaldo Chiara; Stefania Cimbanassi; Alain Chichom Mefire; Dieter Weber; Marco Ceresoli; Andrew B Peitzman; Liban Wehlie; Massimo Sartelli; Salomone Di Saverio; Luca Ansaloni Journal: World J Emerg Surg Date: 2017-08-18 Impact factor: 5.469
Authors: Graeme M Rosenberg; Lisa Knowlton; Charlotte Rajasingh; Yingjie Weng; Paul M Maggio; David A Spain; Kristan L Staudenmayer Journal: JAMA Surg Date: 2017-12-01 Impact factor: 14.766