Is It safe? Nonoperative management of blunt splenic injuries in geriatric trauma patients

The Journal of Trauma and Acute Care Surgery
Marc D TrustCarlos V R Brown

Abstract

Because of increased failure rates of nonoperative management (NOM) of blunt splenic injuries (BSI) in the geriatric population, dogma dictated that this management was unacceptable. Recently, there has been an increased use of this treatment strategy in the geriatric population. However, published data assessing the safety of NOM of BSI in this population is conflicting, and well-powered multicenter data are lacking. We performed a retrospective analysis of data from the National Trauma Data Bank (NTDB) from 2014 and identified young (age < 65) and geriatric (age ≥ 65) patients with a BSI. Patients who underwent splenectomy within 6 hours of admission were excluded from the analysis. Outcomes were failure of NOM and mortality. We identified 18,917 total patients with a BSI, 2,240 (12%) geriatric patients and 16,677 (88%) young patients. Geriatric patients failed NOM more often than younger patients (6% vs. 4%, p < 0.0001). On logistic regression analysis, Injury Severity Score of 16 or higher was the only independent risk factor associated with failure of NOM in geriatric patients (odds ratio, 2.778; confidence interval, 1.769-4.363; p < 0.0001). There was no difference in mortality in geriatric patients who had successful vs....Continue Reading

References

Apr 26, 2000·The Journal of Trauma·C S CocanourJ H Duke
Jun 8, 2000·Archives of Surgery·G C VelmahosD Demetriades
May 24, 2001·The Journal of Trauma·J A NixB L Enderson
Nov 14, 2006·The Journal of Trauma·Gregory A WatsonBrian G Harbrecht
Nov 13, 2008·The Journal of Trauma·Frederick A MooreRobert C McIntyre
Dec 27, 2012·The Journal of Trauma and Acute Care Surgery·Nicole A StassenUNKNOWN Eastern Association for the Surgery of Trauma
Jun 4, 2015·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·G A WatsonA B Peitzman
Jul 8, 2015·The Journal of Trauma and Acute Care Surgery·Rosemary A KozarFred Luchette
Feb 7, 2016·The Journal of Surgical Research·Adrian W OngForrest B Fernandez

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Citations

Apr 20, 2020·Updates in Surgery·Rame BashirJeffry Nahmias

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