TY - JOUR
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.
UR - http://www.scopus.com/inward/record.url?scp=33751246745&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33751246745&partnerID=8YFLogxK
U2 - 10.1080/00015458.2006.11679953
DO - 10.1080/00015458.2006.11679953
M3 - Review article
C2 - 17168271
AN - SCOPUS:33751246745
VL - 106
SP - 566
EP - 571
JO - Acta Chirurgica Belgica
JF - Acta Chirurgica Belgica
SN - 0001-5458
IS - 5
ER -