Document Detail


Risk factors for splenectomy in children with blunt splenic trauma.
MedLine Citation:
PMID:  11877637     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND/PURPOSE: Nonoperative management and splenic preservation have become standards of care for management of pediatric blunt splenic trauma. However, review of the Pennsylvania Trauma Outcome Study (PTOS) registry found that 15% of children with blunt splenic injury still underwent splenectomy. The authors sought to determine the factors that predisposed to splenectomy in this population. METHODS: Between 1993 and 1997, 754 children, ages 0 to 16 years, who sustained blunt splenic trauma were entered in the PTOS database. These patients were stratified into groups according to the mode of management: nonoperative, splenorrhaphy, or splenectomy. Logistic regression was performed to determine factors associated with splenectomy. RESULTS: Overall, 15.1% of patients underwent splenectomy, 7.4% underwent splenorrhaphy, and 77.5% were treated nonoperatively. Spleen injury grade, nonspleen abdominal injuries, Glasgow Coma Scale 3 to 8, and age 15 to 16 years were significant determinants of splenectomy by multivariate analysis. Children treated at pediatric trauma centers (PTC) underwent significantly fewer splenectomies. CONCLUSIONS: Injury grade, but not hemodynamic instability, was a significant independent determinant of splenectomy in children with blunt splenic trauma. Children treated at PTC are less likely to undergo splenectomy. Ongoing analysis of the management of blunt pediatric splenic injury and reduction of unnecessary splenectomies are needed to optimize care for injured children.
Authors:
Douglas A Potoka; Laura C Schall; Henri R Ford
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  37     ISSN:  1531-5037     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  2002 Mar 
Date Detail:
Created Date:  2002-03-05     Completed Date:  2002-04-09     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  294-9     Citation Subset:  IM    
Copyright Information:
Copyright 2002 by W.B. Saunders Company.
Affiliation:
Department of Surgery, University of Pittsburgh and Children's Hospital of Pittsburgh and the Department of Biostatistics, University of Pittsburgh, Pittsburgh, PA, USA.
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MeSH Terms
Descriptor/Qualifier:
Accidents, Traffic
Adolescent
Age Factors
Bicycling
Child
Child, Preschool
Databases as Topic
Glasgow Coma Scale
Humans
Infant
Infant, Newborn
Injury Severity Score
Likelihood Functions
Motor Vehicles
Risk Factors
Spleen / injuries*,  surgery*
Splenectomy / adverse effects*,  statistics & numerical data
Wounds, Nonpenetrating / surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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