{"title":"Surgical Treatment versus Conservative Management of Splenic Rupture: Outcomes and Risk Factors.","authors":"Reza Eshraghi, Sina Shamsi, Masoumeh Safaee","doi":"10.30476/BEAT.2024.101350.1489","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to evaluate the outcome and risk factors in operative and non-operative management of splenic injury.</p><p><strong>Methods: </strong>This cross-sectional study was conducted on patients with traumatic splenic injuries who were hospitalized in Kashani Hospital (Isfahan, Iran) from 2017 to 2019. The studied variables were extracted from the medical records of the enrolled participants. The outcomes such as mortality complications and risk factors were compared based on treatment methods.</p><p><strong>Results: </strong>A total of 240 patients were investigated. The mean age of the patients was 29.8±12.2, with 180 (77.5%) patients being men. 154 (64.2%) patients underwent operative treatment. The mortality rate was 18.9% and 4.6% among operative and non-operative groups (<i>p</i><0.001). Complications were observed in 11.5% and 46.1% of non-operative and operative groups, respectively (<i>p</i><0.001). Operative treatment inversely correlated with mortality (<i>p</i><0.001) and complications (<i>p</i><0.05). Splenic injury severity was correlated positively with mortality (<i>p</i><0.001) and negatively with complications (<i>p</i><0.001). Unstable hemodynamic status was positively correlated with complications (<i>p</i><0.001). Age had a positive correlation with mortality (<i>p</i><0.001) and complications (<i>p</i><0.001). Male sex had a negative correlation with complications (<i>p</i><0.001). GCS score and admission were positively correlated with mortality (<i>p</i><0.001). There was no statistically significant correlation between correlated injuries and outcomes (<i>p</i>≥0.05).</p><p><strong>Conclusion: </strong>Patients who received surgery had higher rates of mortality and complications. However, after controlling for confounders, operative treatment was found to be inversely correlated with mortality and complications.</p>","PeriodicalId":9333,"journal":{"name":"Bulletin of emergency and trauma","volume":"12 1","pages":"15-20"},"PeriodicalIF":0.0000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11057449/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Bulletin of emergency and trauma","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.30476/BEAT.2024.101350.1489","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: This study aimed to evaluate the outcome and risk factors in operative and non-operative management of splenic injury.
Methods: This cross-sectional study was conducted on patients with traumatic splenic injuries who were hospitalized in Kashani Hospital (Isfahan, Iran) from 2017 to 2019. The studied variables were extracted from the medical records of the enrolled participants. The outcomes such as mortality complications and risk factors were compared based on treatment methods.
Results: A total of 240 patients were investigated. The mean age of the patients was 29.8±12.2, with 180 (77.5%) patients being men. 154 (64.2%) patients underwent operative treatment. The mortality rate was 18.9% and 4.6% among operative and non-operative groups (p<0.001). Complications were observed in 11.5% and 46.1% of non-operative and operative groups, respectively (p<0.001). Operative treatment inversely correlated with mortality (p<0.001) and complications (p<0.05). Splenic injury severity was correlated positively with mortality (p<0.001) and negatively with complications (p<0.001). Unstable hemodynamic status was positively correlated with complications (p<0.001). Age had a positive correlation with mortality (p<0.001) and complications (p<0.001). Male sex had a negative correlation with complications (p<0.001). GCS score and admission were positively correlated with mortality (p<0.001). There was no statistically significant correlation between correlated injuries and outcomes (p≥0.05).
Conclusion: Patients who received surgery had higher rates of mortality and complications. However, after controlling for confounders, operative treatment was found to be inversely correlated with mortality and complications.
期刊介绍：
BEAT: Bulletin of Emergency And Trauma is an international, peer-reviewed, quarterly journal coping with original research contributing to the field of emergency medicine and trauma. BEAT is the official journal of the Trauma Research Center (TRC) of Shiraz University of Medical Sciences (SUMS), Hungarian Trauma Society (HTS) and Lusitanian Association for Trauma and Emergency Surgery (ALTEC/LATES) aiming to be a publication of international repute that serves as a medium for dissemination and exchange of scientific knowledge in the emergency medicine and trauma. The aim of BEAT is to publish original research focusing on practicing and training of emergency medicine and trauma to publish peer-reviewed articles of current international interest in the form of original articles, brief communications, reviews, case reports, clinical images, and letters.
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