Twenty-years of splenic preservation at a level 1 pediatric trauma center

Journal of Pediatric Surgery
Sigrid BairdainDavid P Mooney

Abstract

Splenic preservation is the standard of care for hemodynamically stable children with splenic injuries. We report a 20-year single-institutional series of children with splenic injuries managed without a splenectomy. Children evaluated and treated for blunt splenic injury at Boston Children's Hospital from 1994 to 2014 were extracted from the trauma registry. Demographics, clinical characteristics, complications, and outcomes were reviewed. Three time-periods were evaluated based upon the development and modification of splenic injury clinical pathway guidelines (CPGs). Survival was defined as being discharged from the hospital alive. 502 suffered isolated splenic injuries. The median AAST grade of splenic injury increased across the three CPG time periods (p<0.001). No splenic-injury related mortalities occurred. Hospital length of stay decreased significantly secondary to splenic injury CPGs (p<0.001). 99% of the patients were discharged home. In children managed over the last 20years for isolated splenic injury, no patient died or underwent splenectomy. Hospital length of stay decreased across time, despite an increase in the severity of splenic injuries encountered. Splenectomy has become so unusual in the management of hem...Continue Reading

References

Dec 13, 2006·The Journal of Trauma·Michael L NanceDouglas J Wiebe
Mar 23, 2011·American Journal of Surgery·Tolulope A OyetunjiSuryanarayana M Siram
Dec 6, 2011·American Journal of Surgery·Pamela J P BruceJames M Haan
Mar 20, 2012·Journal of Pediatric Surgery·Lindsay A McDonald, Natalie L Yanchar
Sep 4, 2012·The Journal of Surgical Research·Sarah J LippertKathryn D Bass
May 7, 2013·European Journal of Pediatrics·Georg SingerMichael E Hoellwarth

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Citations

Apr 28, 2016·The Journal of Trauma and Acute Care Surgery·Stephen J FentonEric R Scaife
Jun 4, 2016·The Journal of Trauma and Acute Care Surgery·Martha-Conley E IngramMatthew T Santore
Aug 23, 2017·World Journal of Emergency Surgery : WJES·Federico CoccoliniLuca Ansaloni
Mar 1, 2021·World Journal of Emergency Surgery : WJES·Maike GrootenhaarEdward C Tan
Feb 27, 2021·Journal of Vascular and Interventional Radiology : JVIR·Kaitlin ShinnNima Kokabi

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