SynthesisCritical care (London, England)2013
Is non-operative management safe and effective for all splenic blunt trauma? A systematic review.
Synthesis in Critical care (London, England), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03231202 (A Multi-centre, Prospective, Randomized Controlled Study to Compare Outcomes of Non-operative Management), which is not on this map. Cited by 40 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Multi-centre, Prospective, Randomized Controlled Study to Compare Outcomes of Non-operative Management (NOM) With and Without Splenic Arterial Embolization (SAE) in Hemodynamically Stable OIS Grade 4 and 5 Splenic Injuries.
Who cites it
40 citing papers in PubMed, 2 syntheses or guidelines pooled it, 98 citations in OpenAlex.
- Splenic artery embolisation for splenic injury during colonoscopy: A systematic review.United European gastroenterology journal · 2024Pooled it
- Post-traumatic Splenic Injury Outcomes for Nonoperative and Operative Management: A Systematic Review.World journal of surgery · 2021Pooled it
- Comparing non-operative management of abdominal solid organ injuries in pediatric and adult blunt trauma: A meta-analysis and systematic review.Irish journal of medical science · 2026Review
- Using Interpretable Artificial Intelligence Algorithms in the Management of Blunt Splenic Trauma: Applications of Optimal Policy Trees as a Treatment Prescription Aid to Improve Patient Mortality.Bioengineering (Basel, Switzerland) · 2025Article
- Impact of early arterial-phase multidetector CT in blunt spleen injury: a clinical outcomes-oriented study.BMC medical imaging · 2025Article
- Comparative effectiveness of angioembolization versus open surgery in patients with blunt splenic injury.Scientific reports · 2024Article
- Splenic artery embolisation for blunt splenic trauma: 10 years of practice at a trauma centre.Annals of the Royal College of Surgeons of England · 2024Article
- Surgical Treatment versus Conservative Management of Splenic Rupture: Outcomes and Risk Factors.Bulletin of emergency and trauma · 2024Article
- Gunshot Abdominal Injuries: A Report of Two Cases and a Review of the Literature.Medicina (Kaunas, Lithuania) · 2023Review
- Article
- Increased hospital treatment volume of splenic injury predicts higher rates of successful non-operative management and reduces hospital length of stay: a Swiss Trauma Registry analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Current Standards for and Clinical Impact of Emergency Radiology in Major Trauma.International journal of environmental research and public health · 2022Review
- Role of MRI in early follow-up of patients with solid organ injuries: How and why we do it?La Radiologia medica · 2021Article
- Laparoscopic surgery for splenic injuries in the era of non-operative management: current status and future perspectives.Surgery today · 2021Review
- Non-operative management of blunt splenic trauma: evolution, results and controversies.Revista do Colegio Brasileiro de Cirurgioes · 2021Review
- Variations in the management of adolescents with blunt splenic trauma in England and Wales: are we preserving enough?Annals of the Royal College of Surgeons of England · 2020Article
- Splenic trauma, the way forward in reducing splenectomy: our 15-year experience.Annals of the Royal College of Surgeons of England · 2020Article
- Early discharge in selected patients with low-grade renal trauma.World journal of urology · 2020Article
- Intermittent Splenic Artery Occlusion Plus Gauze Compression Is a Simple and Effective Treatment for Iatrogenic Splenic Injury.Medical science monitor : international medical journal of experimental and clinical research · 2020Article
- Delayed Rupture of a Normal Appearing Spleen After Trauma: Is Our Knowledge Enough? Two Case Reports.The American journal of case reports · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe goal of non-operative management (NOM) for blunt splenic trauma (BST) is to preserve the spleen. The advantages of NOM for minor splenic trauma have been extensively reported, whereas its value for the more severe splenic injuries is still debated. The aim of this systematic review was to evaluate the available published evidence on NOM in patients with splenic trauma and to compare it with the operative management (OM) in terms of mortality, morbidity and duration of hospital stay.
methodsFor this systematic review we followed the "Preferred Reporting Items for Systematic Reviews and Meta-analyses" statement. A systematic search was performed on PubMed for studies published from January 2000 to December 2011, without language restrictions, which compared NOM vs. OM for splenic trauma injuries and which at least 10 patients with BST.
resultsWe identified 21 non randomized studies: 1 Clinical Controlled Trial and 20 retrospective cohort studies analyzing a total of 16,940 patients with BST. NOM represents the gold standard treatment for minor splenic trauma and is associated with decreased mortality in severe splenic trauma (4.78% vs. 13.5% in NOM and OM, respectively), according to the literature. Of note, in BST treated operatively, concurrent injuries accounted for the higher mortality. In addition, it was not possible to determine post-treatment morbidity in major splenic trauma. The definition of hemodynamic stability varied greatly in the literature depending on the surgeon and the trauma team, representing a further bias. Moreover, data on the remaining analyzed outcomes (hospital stay, number of blood transfusions, abdominal abscesses, overwhelming post-splenectomy infection) were not reported in all included studies or were not comparable, precluding the possibility to perform a meaningful cumulative analysis and comparison.
conclusionsNOM of BST, preserving the spleen, is the treatment of choice for the American Association for the Surgery of Trauma grades I and II. Conclusions are more difficult to outline for higher grades of splenic injury, because of the substantial heterogeneity of expertise among different hospitals, and potentially inappropriate comparison groups.
Indexed as
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.