Isolated high-grade splenic injury among pediatric patients in Japan: Nationwide descriptive study
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In brief
In brief
Nationwide Japanese study of 230 pediatric patients with high-grade splenic injury demonstrates 100% survival and 97% splenic salvage rates between 2004-2018. Nonoperative management was used in 68% of cases, with splenic artery embolization employed in 27%—notably higher than Western practice patterns.
Written by the GCMD Library team from the article.
Abstract
Background
Limited information exists regarding the clinical characteristics, management practice, and outcomes of pediatric patients with isolated splenic injury in Japan. This study aimed to evaluate the characteristics, management, and outcomes, such as survival and splenic salvage rate of pediatric patients with isolated splenic injury in Japan.
Method
This study was a multicenter retrospective cohort study using patient data from the Japan Trauma Data Bank (JTDB) collected between 2004 and 2018. Pediatric patients with isolated high-grade splenic injury whose abbreviated injury scale≥3 were classified according to management groups: nonoperative management (NOM); NOM with splenic artery embolization (SAE); and operative management (OM). The primary outcome was in-hospital survival and the secondary outcomes were splenic salvage rate, hospital length of stay (LOS), rate of discharging to home, and complications.
Results
There were 230 pediatric patients with isolated high-grade splenic injury during the study period. Of these, 156 (68%) were managed by NOM, 62 (27%) were managed by NOM with SAE, and 12 (5.2%) were managed by OM. No pediatric patient with isolated high-grade splenic injury died between 2004 and 2018 in Japan, and the splenic salvage rate was 97%.
Conclusion
We identified a high survival rate and splenic salvage rate among pediatric patients with isolated high-grade splenic injury in Japan. SAE was often used, in contrast with previous reports.
Levels of evidence
Level IV.