Blunt Splenic Injuries: Have We Watched Long Enough?

• DOI: 10.1097/ta.0b013e3181650fb4
• Publication Date: 2009-03-05T16:00:18Z
• Authors: Jason Smith; Scott Armen; Charles H. Cook; Larry C. Martin
• Keywords: Trauma Center

Nonoperative management (NOM) of blunt splenic injuries (BSIs) has been used with increasing frequency in adult patients. There are currently no definitive guidelines established for how long BSI patients should be monitored failure NOM after injury.This study was performed to ascertain the length inpatient observation needed capture most failures, and identify factors associated NOM. We utilized National Trauma Data Bank determine time BSI.During 5-year period, 23,532 were identified BSI, which 2,366 (10% overall) taken directly surgery (within 2 hours arrival). Of 21,166 initially managed nonoperatively, 18,506 successful (79% all-comers). Patients isolated approximately 5 days as inpatients. failing NOM, 95% failed during first 72 hours, monitoring additional saw only 1.5% more failures. Factors influencing success included computed tomographic injury grade, severity patient injury, American College Surgeons designation trauma center. Importantly, who did not seem have detrimental outcomes when compared No statistically significant predictive variables could that would help predict go on fail NOM.We conclude at least 80% can successfully inpatients 3 days.