J Korean Soc Traumatol.  2017 Sep;30(3):91-97. 10.20408/jti.2017.30.3.91.

Treatment Option for High Grade Spleen Injury and Predictive Factors for Non-operative Management

• Na JW
• Lee JN
• Yu BC
• Lee MA
• Park JJ
• Lee GJ

• KMID: 2394562
• DOI: http://doi.org/10.20408/jti.2017.30.3.91

Abstract

PURPOSE
The prognostic factors of non-operative management (NOM) in high-grade spleen injuries have been extensively studied, but factors that would help treatment decisions are lacking. We compared the characteristics of the patients to identify the factors affecting treatment choices.
METHODS
This is a review of 207 blunt spleen injury patients from January 2004 to December 2013. We compared clinical features and mortality between surgery and NOM, and used multivariate regression analysis to find the factor most strongly associated with prognosis.
RESULTS
Of the 207 patients, 107 had high-grade spleen injury patents (grade III or above). Of these, 42 patients underwent surgery and 65 patients underwent NOM. The mortality was 7% following surgery, 3% with NOM. The amount of packed red blood cells transfused in the first 24 hours and spleen injury grade were associated with management type, and mortality was highly associated with activated partial thromboplastin time (aPTT) and spleen injury grade.
CONCLUSIONS
The grade of spleen injury was associated with management and mortality, so correctly assessing the spleen injury grade is important.

Keyword

Spleen injury; Blunt trauma; Non-operative management

MeSH Terms

Erythrocytes
Humans
Mortality
Partial Thromboplastin Time
Prognosis
Spleen*