Cirrhosis increases mortality and splenectomy rates following splenic injury
| Autor: | Saman Arbabi, Lindsay Cattin, Jennifer M. Burg, Kelly A. Fair, Arvin Gee, Martin A. Schreiber, Mackenzie R. Cook |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Liver Cirrhosis Male medicine.medical_specialty Cirrhosis medicine.medical_treatment Splenectomy Abdominal Injuries Wounds Nonpenetrating Gastroenterology Liver disease Internal medicine medicine Humans Prospective Studies Risk factor business.industry General Medicine Odds ratio Middle Aged medicine.disease Confidence interval United States Surgery Survival Rate Abdominal trauma Propensity score matching Female business Spleen Follow-Up Studies |
| Zdroj: | American journal of surgery. 209(5) |
| ISSN: | 1879-1883 |
| Popis: | Background Cirrhosis may be a risk factor for mortality following blunt splenic injury (BSI) and it predicts the need for an operative intervention. Methods We performed a case–control study at 3 level 1 trauma centers. Comparisons were made with chi-square test, Wilcoxon rank-sum test, and binary logistic regression, and stratified by propensity for splenectomy. Data are presented as odds ratios (ORs) and 95% confidence intervals (95% CIs). Results Mortality was 27% (21/77) and cirrhosis was a strong risk factor for death (OR 8.8, 95% CI 3.7 to 21.1). Compared with controls, cirrhosis was an independent risk factor for splenectomy (OR 5.4, 95% CI 2.5 to 11.5), and only splenic injury grade was associated with splenectomy (OR 2.2, 95% CI 1.3 to 3.6). Only admission model for end-stage liver disease was independently associated with mortality after an operation (OR 1.7, 95% CI 1.1 to 2.8). After propensity score matching, we found no association between splenectomy and mortality in cirrhotic patients. Conclusion Cirrhosis dramatically increases mortality and the odds of an operative intervention in BSI patients with pre-existing cirrhosis, and BSI requires vigilant attention and early intervention should be considered. |
| Databáze: | OpenAIRE |
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