Management of blunt hepatic and splenic trauma in a Greek level I trauma centre

H. Markogiannakis, E. Sanidas, E. Messaris, I. Michalakis, G. Kasotakis, J. Melissas, D. Tsiftsis

Research output: Contribution to journalReview article

7 Citations (Scopus)

Abstract

Background and purposes: Non-operative management (NOM) has revolutionized the care of blunt hepatic and splenic trauma patients. The objective of this study is to evaluate treatment of such patients in a Greek level I trauma centre, to identify factors that are important for selecting them for NOM and to investigate for predictors of NOM failure. Material and methods: We reviewed the Trauma Registry data of 96 consecutive adult patients admitted with blunt liver and/or splenic injuries over a 4-year period. Results: Immediately operated patients (32.3%) had lower diastolic arterial pressure (p = 0.02), lower International Classification of Diseases -9th revision Injury Severity Score (ICISS) (p = 0.01), and a higher grade of splenic injury (p = 0.002) than NOM patients. NOM success rate was 80%. No predictors of NOM failure were found; however, isolated splenic trauma patients failed NOM more frequently than hepatic patients (p = 0.02). Conclusions: NOM of adult blunt hepatic and splenic trauma patients is safe and efficient. Haemodynamic stability, ICISS and the grade of splenic injury are important for selecting these patients for NOM while splenic trauma patients need more intense observation.

Original languageEnglish (US)
Pages (from-to)566-571
Number of pages6
JournalActa Chirurgica Belgica
Volume106
Issue number5
DOIs
StatePublished - Oct 2006

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Trauma Centers
Liver
Wounds and Injuries
Injury Severity Score
International Classification of Diseases
Registries
Arterial Pressure
Hemodynamics
Observation
Blood Pressure

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Markogiannakis, H., Sanidas, E., Messaris, E., Michalakis, I., Kasotakis, G., Melissas, J., & Tsiftsis, D. (2006). Management of blunt hepatic and splenic trauma in a Greek level I trauma centre. Acta Chirurgica Belgica, 106(5), 566-571. https://doi.org/10.1080/00015458.2006.11679953
Markogiannakis, H. ; Sanidas, E. ; Messaris, E. ; Michalakis, I. ; Kasotakis, G. ; Melissas, J. ; Tsiftsis, D. / Management of blunt hepatic and splenic trauma in a Greek level I trauma centre. In: Acta Chirurgica Belgica. 2006 ; Vol. 106, No. 5. pp. 566-571.
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Markogiannakis, H, Sanidas, E, Messaris, E, Michalakis, I, Kasotakis, G, Melissas, J & Tsiftsis, D 2006, 'Management of blunt hepatic and splenic trauma in a Greek level I trauma centre', Acta Chirurgica Belgica, vol. 106, no. 5, pp. 566-571. https://doi.org/10.1080/00015458.2006.11679953

Management of blunt hepatic and splenic trauma in a Greek level I trauma centre. / Markogiannakis, H.; Sanidas, E.; Messaris, E.; Michalakis, I.; Kasotakis, G.; Melissas, J.; Tsiftsis, D.

In: Acta Chirurgica Belgica, Vol. 106, No. 5, 10.2006, p. 566-571.

Research output: Contribution to journalReview article

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T1 - Management of blunt hepatic and splenic trauma in a Greek level I trauma centre

AU - Markogiannakis, H.

AU - Sanidas, E.

AU - Messaris, E.

AU - Michalakis, I.

AU - Kasotakis, G.

AU - Melissas, J.

AU - Tsiftsis, D.

PY - 2006/10

Y1 - 2006/10

N2 - Background and purposes: Non-operative management (NOM) has revolutionized the care of blunt hepatic and splenic trauma patients. The objective of this study is to evaluate treatment of such patients in a Greek level I trauma centre, to identify factors that are important for selecting them for NOM and to investigate for predictors of NOM failure. Material and methods: We reviewed the Trauma Registry data of 96 consecutive adult patients admitted with blunt liver and/or splenic injuries over a 4-year period. Results: Immediately operated patients (32.3%) had lower diastolic arterial pressure (p = 0.02), lower International Classification of Diseases -9th revision Injury Severity Score (ICISS) (p = 0.01), and a higher grade of splenic injury (p = 0.002) than NOM patients. NOM success rate was 80%. No predictors of NOM failure were found; however, isolated splenic trauma patients failed NOM more frequently than hepatic patients (p = 0.02). Conclusions: NOM of adult blunt hepatic and splenic trauma patients is safe and efficient. Haemodynamic stability, ICISS and the grade of splenic injury are important for selecting these patients for NOM while splenic trauma patients need more intense observation.

AB - Background and purposes: Non-operative management (NOM) has revolutionized the care of blunt hepatic and splenic trauma patients. The objective of this study is to evaluate treatment of such patients in a Greek level I trauma centre, to identify factors that are important for selecting them for NOM and to investigate for predictors of NOM failure. Material and methods: We reviewed the Trauma Registry data of 96 consecutive adult patients admitted with blunt liver and/or splenic injuries over a 4-year period. Results: Immediately operated patients (32.3%) had lower diastolic arterial pressure (p = 0.02), lower International Classification of Diseases -9th revision Injury Severity Score (ICISS) (p = 0.01), and a higher grade of splenic injury (p = 0.002) than NOM patients. NOM success rate was 80%. No predictors of NOM failure were found; however, isolated splenic trauma patients failed NOM more frequently than hepatic patients (p = 0.02). Conclusions: NOM of adult blunt hepatic and splenic trauma patients is safe and efficient. Haemodynamic stability, ICISS and the grade of splenic injury are important for selecting these patients for NOM while splenic trauma patients need more intense observation.

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Markogiannakis H, Sanidas E, Messaris E, Michalakis I, Kasotakis G, Melissas J et al. Management of blunt hepatic and splenic trauma in a Greek level I trauma centre. Acta Chirurgica Belgica. 2006 Oct;106(5):566-571. https://doi.org/10.1080/00015458.2006.11679953