Nonoperative Management of Blunt Splenic Trauma: Outcomes of Gelfoam Embolization of the Splenic Artery

Autor:	Heidi Isreal, Kena Vyas, Vicki Moran, A. Fang, Carl R. Freeman, Shuran Ma
Jazyk:	angličtina
Rok vydání:	2018
Předmět:	medicine.medical_specialty splenic embolization complications medicine.medical_treatment Blunt splenic trauma Context (language use) Splenic artery 030218 nuclear medicine & medical imaging law.invention 03 medical and health sciences 0302 clinical medicine law medicine.artery parasitic diseases medicine Embolization business.industry Trauma center lcsh:Medical emergencies. Critical care. Intensive care. First aid Glasgow Coma Scale 030208 emergency & critical care medicine lcsh:RC86-88.9 medicine.disease Intensive care unit Surgery gelfoam nonoperative management Emergency Medicine Injury Severity Score Original Article business
Zdroj:	Journal of Emergencies, Trauma, and Shock Journal of Emergencies, Trauma and Shock, Vol 11, Iss 4, Pp 293-297 (2018)
ISSN:	0974-519X 0974-2700
Popis:	Context: Nonoperative management (NOM) is the standard of care in hemodynamically stable trauma patients with blunt splenic injury. Gelfoam splenic artery embolization (SAE) is a treatment option used in trauma patients. Aims: The primary aim of this study was to retrospectively examine the use and outcomes of Gelfoam SAE in adult patients with blunt splenic injury. Settings and Design: One hundred and thirty-two adult patients with blunt splenic injury admitted to a Level 1 trauma center between January 2014 and December 2015 were included in the study. Patients treated with Gelfoam SAE, NOM, and splenectomies were reviewed. Descriptive statistics including patient age, Glasgow Coma Scale, Injury Severity Score (ISS), hospital days, Intensive Care Unit (ICU) days, splenic grade, and amount of blood products administered were recorded. Complications, defined as any additional factors that contributed to the patient's overall length of hospital stay, were compared between the three groups. Technical aspects of Gelfoam SAE and associated complications were reviewed. Subjects and Methods: Gelfoam SAE was performed in 25 (18.9%) of the 132 patients. Gelfoam SAE patients had fewer ICU days compared with those patients who had a splenectomy or NOM. There was no statistical difference in complications between patients who underwent Gelfoam SAE and those who did not. Patients who underwent Gelfoam SAE tended to have fewer complications including deep venous thrombosis's, PE, and infections and yielded no complications in 64% of the Gelfoam group. Statistical Analysis: Statistical analysis included descriptives, ANOVA, and nonparametric tests as appropriate. Conclusion: Gelfoam SAE can be used for blunt splenic injury for intermediate ISS and splenic grade as it reduced hospital and ICU days.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::bf7ef0540dbcd4b0d76142afcc84c547 http://europepmc.org/articles/PMC6262655 Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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