Comparative effectiveness of treatment strategies for severe splenic trauma in the pediatric population.

Published

Journal Article

BACKGROUND: Splenic angioembolization (SAE) is increasingly used in the management of splenic injuries in adults, although its value in pediatric trauma is unclear. We sought to assess outcomes related to splenectomy vs SAE. METHODS: The National Trauma Data Bank was queried for patients 0 to 15 years of age from 2007 to 2011. Subgroup analysis of splenectomy vs SAE was performed for high-grade injuries using propensity analysis and inverse probability weighting. RESULTS: Of 11,694 children presenting with splenic trauma, over 90% were treated nonoperatively. Adjusted analysis of high-grade injuries included 265 children who underwent splenectomy and 199 who underwent SAE. The Injury Severity Score, number of transfusions, and complications rates were not significantly different between the 2 groups. Overall adjusted mortality for children with high-grade injuries was 13.4% following splenectomy and 10.0% following SAE (P = .31) CONCLUSION: Patients undergoing SAE for high-grade splenic trauma have comparable morbidity and mortality with splenectomy.

Full Text

Duke Authors

Cited Authors

  • Rialon, KL; Englum, BR; Gulack, BC; Guevara, CJ; Bhattacharya, SD; Shapiro, ML; Rice, HE; Scarborough, JE; Adibe, OO

Published Date

  • October 2016

Published In

Volume / Issue

  • 212 / 4

Start / End Page

  • 786 - 793

PubMed ID

  • 26303881

Pubmed Central ID

  • 26303881

Electronic International Standard Serial Number (EISSN)

  • 1879-1883

Digital Object Identifier (DOI)

  • 10.1016/j.amjsurg.2015.06.009

Language

  • eng

Conference Location

  • United States