American Society of Emergency Radiology Multicenter Blunt Splenic Trauma Study: CT and Clinical Findings
| Autor: | Emily Slade, Naga R Chinapuvvula, Adam Dugan, Armonde A. Baghdanian, Richard HungKai Tsai, James T. Lee, Ken F Linnau, Matthew Dattwyler, Carl Flink, Arthur H. Baghdanian, Suzanne T Chong, Scott D. Steenburg, Jennifer Uyeda, Demetrios Raptis, Christina A. LeBedis |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male medicine.medical_specialty MEDLINE Wounds Nonpenetrating Blunt splenic trauma 030218 nuclear medicine & medical imaging 03 medical and health sciences Injury Severity Score 0302 clinical medicine Emergency radiology Humans Medicine Radiology Nuclear Medicine and imaging Societies Medical Retrospective Studies business.industry General surgery Length of Stay medicine.disease United States 030220 oncology & carcinogenesis Female Emergency Service Hospital Tomography X-Ray Computed business Spleen |
| Zdroj: | Radiology. 299:122-130 |
| ISSN: | 1527-1315 0033-8419 |
| DOI: | 10.1148/radiol.2021202917 |
| Popis: | Background Treatment of blunt splenic trauma (BST) continues to evolve with improved imaging for detection of splenic vascular injuries. Purpose To report on treatments for BST from 11 trauma centers, the frequency and clinical impact of splenic vascular injuries, and factors influencing treatment. Materials and Methods Patients were retrospectively identified as having BST between January 2011 and December 2018, and clinical, imaging, and outcome data were recorded. Patient data were summarized descriptively, both overall and stratified by initial treatment received (nonoperative management [NOM], angiography, or surgery). Regression analyses were used to examine the primary outcomes of interest, which were initial treatment received and length of stay (LOS). Results This study evaluated 1373 patients (mean age, 42 years ± 18; 845 men). Initial treatments included NOM in 849 patients, interventional radiology (IR) in 240 patients, and surgery in 284 patients. Rates from CT reporting were 22% (304 of 1373) for active splenic hemorrhage (ASH) and 20% (276 of 1373) for contained vascular injury (CVI). IR management of high-grade injuries increased 15.6%, from 28.6% (eight of 28) to 44.2% (57 of 129) (2011-2012 vs 2017-2018). Patients who were treated invasively had a higher injury severity score (odds ratio [OR], 1.04; 95% CI: 1.02, 1.05 |
| Databáze: | OpenAIRE |
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