ArticlePloS one2017
Recent trends in 30-day mortality in patients with blunt splenic injury: A nationwide trauma database study in Japan.
Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed.
- Outcomes and costs in splenectomy after failed splenic arterial embolization for blunt splenic injury.Surgery open science · 2025Article
- Early versus late surgery after cervical spinal cord injury: a Japanese nationwide trauma database study.Journal of orthopaedic surgery and research · 2019Article
- Non-operative management of blunt splenic injury: is it really so extensively feasible? a critical appraisal of a single-center experience.The Pan African medical journal · 2019Article
- Comparison of the effectiveness of pericardiocentesis and surgical pericardiotomy in the prognosis of patients with blunt traumatic cardiac tamponade: a multicenter study using the Japan Trauma Data Bank.Acute medicine & surgeryArticle
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9 authors.
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Abstract
backgroundSplenic injury frequently occurs after blunt abdominal trauma; however, limited epidemiological data regarding mortality are available. We aimed to investigate mortality rate trends after blunt splenic injury in Japan.
methodsWe retrospectively identified 1,721 adults with blunt splenic injury (American Association for the Surgery of Trauma splenic injury scale grades III-V) from the 2004-2014 Japan Trauma Data Bank. We grouped the records of these patients into 3 time phases: phase I (2004-2008), phase II (2009-2012), and phase III (2013-2014). Over the 3 phases, we analysed 30-day mortality rates and investigated their association with the prevalence of certain initial interventions (Mantel-Haenszel trend test). We further performed multiple imputation and multivariable analyses for comparing the characteristics and outcomes of patients who underwent TAE or splenectomy/splenorrhaphy, adjusting for known potential confounders and for within-hospital clustering using generalised estimating equation.
resultsOver time, there was a significant decrease in 30-day mortality after splenic injury (p < 0.01). Logistic regression analysis revealed that mortality significantly decreased over time (from phase I to phase II, odds ratio: 0.39, 95% confidence interval: 0.22-0.67; from phase I to phase III, odds ratio: 0.34, 95% confidence interval: 0.19-0.62) for the overall cohort. While the 30-day mortality for splenectomy/splenorrhaphy diminished significantly over time (p = 0.01), there were no significant differences regarding mortality for non-operative management, with or without transcatheter arterial embolisation (p = 0.43, p = 0.29, respectively).
conclusionsIn Japan, in-hospital 30-day mortality rates decreased significantly after splenic injury between 2004 and 2014, even after adjustment for within-hospital clustering and other factors independently associated with mortality. Over time, mortality rates decreased significantly after splenectomy/splenorrhaphy, but not after non-operative management. This information is useful for clinicians when making decisions about treatments for patients with blunt splenic injury.
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