Abstract
The nonoperative management (NOM) protocol with angioembolization (AE) presents a trend in dealing with trauma patients with blunt splenic injury (BSI). This study was designed to explore the adverse events and associated risk factors before and after protocol-based NOM of BSI over a 12-year period. A retrospective study was performed on adult trauma patients with BSI who were admitted from 2005 to 2016. The patients were divided into before cohort (2005-2010) and after cohort (2011-2016). Multivariate logistic regression analysis was performed to identify risk factors associated with the morbidity. The primary outcomes are NOM-related mortality and total number of complications, the secondary outcome is the incidence of each complication. The before cohort was composed of 209 patients, and the after cohort had 190 patients. There was a significant increase in the use of AE (from 18.1% to 47.5%, p < 0.001) with a higher incidence of patients who had a shock episode before AE (from 4.2% to 16.5%, p < 0.001). Regarding the outcomes, there were no significant differences in the incidences of NOM-related mortality between the after than before cohorts. However, there were 190 complications in 71 patients in the before cohort but 28...Continue Reading
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