Risk factors associated with splenectomy following a blunt splenic injury in pediatric patients
link.springer.com shows its articles on its own site.
Read the article on link.springer.com ↗Article · Oct 2020 · 1 min read
In brief
In brief
Analysis of 1,297 pediatric blunt splenic injury cases identified blood transfusion within 4 hours and high-grade injury severity as primary predictors of splenectomy, with only 4.4% requiring operative intervention. Findings support risk stratification for nonoperative management in pediatric splenic trauma.
Written by the GCMD Library team from the article.
Abstract
Purpose
The purpose of the study was to identify the factors associated with splenectomy in pediatric trauma patients.
Method
Pediatric Trauma quality improvement program (P-TQIP) database calendar year 2014–2016 was accessed for the study. All patients, age ≤ 18 years old, who sustained splenic injury due to blunt mechanism, were included in the study. The primary outcome of the study was to identify the risk factors associated with splenectomy. Univariate followed by multivariate analyses were performed. A p value of < 0.05 was considered an indication of statistical significance.
Results
Of 1297 trauma victims, who fulfilled the inclusion criteria, 57 (4.4%) patients underwent total splenectomy. In Univariate analysis, there were significant differences found, in many variables, between the groups who underwent splenectomy versus those who did not have splenectomy. A multivariate logistic regression analysis showed use of blood transfusion within 4 h and severity of splenic injury were the two variables associated with splenectomy. The area under the curve (AUC) value was 0.892 and the 95% confidence intervals were [0.859, 0.923].
Conclusion
Blood transfusion within 4 h of patient’s arrival to the hospital and high-grade splenic injury were main factors for splenectomy in the pediatric population.