J Trauma Inj.  2022 Sep;35(3):189-194. 10.20408/jti.2021.0065.

Could the Injury Severity Score be a new indicator for surgical treatment in patients with traumatic splenic injury?

• Jeong H
• Jung S
• Heo TG
• Choi PW
• Kim JI
• Jung SM
• Jun H
• Shin YC
• Um E

• KMID: 2540358
• DOI: http://doi.org/10.20408/jti.2021.0065

Abstract

Purpose
The purpose of this study was to determine whether a higher Injury Severity Score (ISS) could serve as an indicator of splenectomy in patients with traumatic splenic lacerations.
Methods
A total of 256 cases of splenic laceration were collected from January 1, 2005 to December 31, 2018. After the application of exclusion criteria, 105 were eligible for this study. Charts were reviewed for demographic characteristics, initial vital signs upon presentation to the emergency room, Glasgow Coma Scale, computed tomography findings, ISS, and treatment strategies. The cases were then divided into nonsplenectomy and splenectomy groups for analysis.
Results
When analyzed with the chi-square test and t-test, splenectomy was associated with a systolic blood pressure lower than 90 mmHg, a Glasgow Coma Scale score lower than 13, active bleeding found on computed tomography, a splenic laceration grade greater than or equal to 4, and an ISS greater than 15 at presentation. However, in multivariate logistic regression analysis, only active bleeding on computed tomography showed a statistically significant relationship (P=0.014).
Conclusions
Although ISS failed to show a statistically significant independent relationship with splenectomy, it may still play a supplementary role in traumatic splenic injury management.

Keyword

Splenic laceration; Injury Severity Score; Trauma; Splenectomy