Splenic Injury
Conditions
Keywords
spleen, injury, patient transfer, splenectomy, embolization, theurapeutic
Brief summary
In blunt trauma, the spleen is most frequent injured organ in the abdomen and the most frequent source of bleeding in the abdomen. Historically, splenectomy was the treatment of choice for splenic bleeding. For exsanguinating patients, open splenectomy is still the proper choice of treatment if the spleen is a significant source of bleeding. However, for hemodynamic stable patients with splenic injury, non-operative management (NOM) is an alternative, assuming they have no other indication for surgery (peritonitis). Non-operative management includes observation and/or splenic artery embolisation (SAE), but the indications for observation and SAE varies between trauma centers. The greatest advantage of NOM is the preservation of splenic function. In the investigators hospital splenic artery embolisation was introduced in 2007. The investigators want to describe the treatment of splenic injuries in their hospital, to see if the number of splenectomies has been recduced after 2007, and to see if SAE has also been used in transferred trauma patients.
Interventions
PROCEDURETreatment of splenic injury
There are four possible treatments of splenic injury in this study: * splenectomy * splenic artery embolisation * non-operative management * any combination of the three treatments mentioned
Sponsors
University Hospital of North Norway
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* All patients admitted at UNN Tromsø in the period of 01.01.2000 - 31.12.2013 and with the discharge diagnosis S36.0 Splenic injury (ICD-10)
Exclusion criteria
* no injury/coding error * iatrogenic injury * transfer \>7 days after injury * \>10 days between injury and first hospital admission
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| type of splenic trauma treatment | 0-7 days | There are three different treatments of splenic trauma treatment, resulting in four different treatments: * splenectomy * splenic artery embolization * non-operative management * any combination of the three treatments |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Mortality | 30 days | — |
| Length of hospital stay | 1 - 90 days | — |
| Length of stay in the intensive care unit | 0 - 90 days | — |
| Emergency procedures | 0 - 7 days | Emergency procedures includes: * Chest tube insertion * Hemostatic surgery in the abdomen * Hemostatic surgery in the pelvis with packing * Thoracotomy * Primary stabilization of fractures (external fixation) * Endotracheal intubation |
Countries
Norway
Outcome results
None listed