TY - JOUR
T1 - Age should not be a consideration for nonoperative management of blunt splenic injury
AU - Cocanour, Christine S
AU - Moore, Frederick A.
AU - Ware, Drue N.
AU - Marvin, Robert G.
AU - Duke, James H.
PY - 2000/4
Y1 - 2000/4
N2 - Background: Operative management of blunt splenic injury is recommended for adults ≥ 55 years. Because this is not our practice, we did a retrospective review to compare outcomes of patients ≥ 55 years old versus patients < 55 years old. Methods: During a 5-year period ending in July of 1998, 461 patients (3%) admitted to our Level I trauma center had a blunt splenic injury. Eighty-six patients (19%) died within 24 hours of massive injuries, leaving 375 patients for evaluation. Data were obtained from our trauma registry and medical records. Results: A total of 29 patients (8%) were ≥ 55 years old (mean age, 67 ± 2 years; mean injury severity score [ISS] 25 ± 2). Of these, 18 patients (62%) underwent nonoperative management (NOM). A total of 346 patients (92%) were < 55 years old (mean age, 28 ± 0.6; mean ISS, 20 ± 1). Of these, 198 patients (57%) underwent NOM. The failure rate was not different between the two age groups (17% vs. 14%). However, the ISS and mortality rate were significantly higher in the older age group teat failed (ISS, 29.3 ± 2.6 vs. 19.5 ± 2.1; mortality: 67% vs. 4%). None of the deaths could be attributed to splenic injury. Conclusion: Adults ≥ 55 years old with blunt splenic injury are successfully treated by NOM. Although older adults had significantly greater injuries, they had similar failure rates of NOM when compared with younger adults. Older adults had significantly higher mortality, but this was not a result of their splenic injury. Therefore, age should not be a criteria for NOM of blunt splenic injury.
AB - Background: Operative management of blunt splenic injury is recommended for adults ≥ 55 years. Because this is not our practice, we did a retrospective review to compare outcomes of patients ≥ 55 years old versus patients < 55 years old. Methods: During a 5-year period ending in July of 1998, 461 patients (3%) admitted to our Level I trauma center had a blunt splenic injury. Eighty-six patients (19%) died within 24 hours of massive injuries, leaving 375 patients for evaluation. Data were obtained from our trauma registry and medical records. Results: A total of 29 patients (8%) were ≥ 55 years old (mean age, 67 ± 2 years; mean injury severity score [ISS] 25 ± 2). Of these, 18 patients (62%) underwent nonoperative management (NOM). A total of 346 patients (92%) were < 55 years old (mean age, 28 ± 0.6; mean ISS, 20 ± 1). Of these, 198 patients (57%) underwent NOM. The failure rate was not different between the two age groups (17% vs. 14%). However, the ISS and mortality rate were significantly higher in the older age group teat failed (ISS, 29.3 ± 2.6 vs. 19.5 ± 2.1; mortality: 67% vs. 4%). None of the deaths could be attributed to splenic injury. Conclusion: Adults ≥ 55 years old with blunt splenic injury are successfully treated by NOM. Although older adults had significantly greater injuries, they had similar failure rates of NOM when compared with younger adults. Older adults had significantly higher mortality, but this was not a result of their splenic injury. Therefore, age should not be a criteria for NOM of blunt splenic injury.
KW - Age
KW - Nonoperative management
KW - Splenic injury
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M3 - Article
C2 - 10780591
AN - SCOPUS:0034000560
VL - 48
SP - 606
EP - 612
JO - Journal of Trauma and Acute Care Surgery
JF - Journal of Trauma and Acute Care Surgery
SN - 2163-0755
IS - 4
ER -