More Becomes Less: Management Strategy Has Definitely Changed over the Past Decade of Splenic InjuryA Nationwide Population-Based StudyReport as inadecuate




More Becomes Less: Management Strategy Has Definitely Changed over the Past Decade of Splenic InjuryA Nationwide Population-Based Study - Download this document for free, or read online. Document in PDF available to download.

BioMed Research International - Volume20152015, Article ID124969, 6 pages -

Research Article

Division of Trauma, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan

Department of Emergency Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan

Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan

Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan

Nutrition Support Team, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan

Division of Gastrointestinal and General Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan

Department of Surgery, Faculty of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan

Graduate Institute of Clinical Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan

Received 26 March 2014; Accepted 14 August 2014

Academic Editor: Wei-PinChang

Copyright 2015 Kwan-Ming Soo et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Blunt spleen injury is generally taken as major trauma which is potentially lethal. However, the management strategy has progressively changed to noninvasive treatment over the decade. This study aimed to 1 find out the incidence and trend of strategy change; 2 investigate the effect of change on the mortality rate over the study period; and 3 evaluate the risk factors of mortality. Materials and Methods. We utilized nationwide population-based data to explore the incidence of BSI during a 12-year study period. The demographic characteristics, including gender, age, surgical intervention, blood transfusion, availability of CT scans, and numbers of coexisting injuries, were collected for analysis. Mortality, hospital length of stay, and cost were as outcome variables. Results. 578 splenic injuries were recorded with an estimated incidence of 48 per million per year. The average 12-year overall mortality rate during hospital stay was 5.28% 29-549. There is a trend of decreasing operative management in patients , . The risk factors for mortality in BSI from a multivariate logistic regression analysis were amount of transfusion OR 1.033, , CI 1.0171.049, with or without CT obtained OR 0.347, , CI 0.1580.889, and numbers of coexisting injuries OR 1.346, , CI 1.0101.842. Conclusion. Although uncommon of BSI, management strategy is obviously changed to nonoperative treatment without increasing mortality and blood transfusion under the increase of CT utilization. Patients with more coexisting injuries and more blood transfusion had higher mortality.





Author: Kwan-Ming Soo,Tsung-Ying Lin,Chao-Wen Chen,Yen-Ko Lin,Liang-Chi Kuo,Jaw-Yuan Wang,Wei-Che Lee,and Hsing-Lin Lin

Source: https://www.hindawi.com/



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