Evidence map›Paper›PMID 29387960›Full record

ArticleWorld journal of surgery2018

Nonoperative Management of Blunt Splenic Trauma in Patients with Traumatic Brain Injury: Feasibility and Outcomes.

Navpreet K Dhillon, Galinos Barmparas, Gretchen M Thomsen, Kavita A Patel, Nikhil T Linaval, Emma Gillette, Daniel R Margulies, Eric J Ley

Abstract read
PubMed Publisher
In one paragraph

Article in World journal of surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.7field-weighted citation impact, top 17% of its field
1 · What the graph read from 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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Article
  3. Non-operative management for abdominal solidorgan injuries: A literature review.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2022
    Review
  4. Article
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Navpreet K DhillonDivision of Trauma and Critical Care, Department of Surgery, Cedars-Sinai Medical Center, 8635 West 3rd Street, Suite 650 W, Los Angeles, CA, 90048, USA.
Galinos BarmparasDivision of Trauma and Critical Care, Department of Surgery, Cedars-Sinai Medical Center, 8635 West 3rd Street, Suite 650 W, Los Angeles, CA, 90048, USA. Galinos.Barmparas@cshs.org.
Gretchen M ThomsenDivision of Trauma and Critical Care, Department of Surgery, Cedars-Sinai Medical Center, 8635 West 3rd Street, Suite 650 W, Los Angeles, CA, 90048, USA.
Kavita A PatelDivision of Trauma and Critical Care, Department of Surgery, Cedars-Sinai Medical Center, 8635 West 3rd Street, Suite 650 W, Los Angeles, CA, 90048, USA.
Nikhil T LinavalDivision of Trauma and Critical Care, Department of Surgery, Cedars-Sinai Medical Center, 8635 West 3rd Street, Suite 650 W, Los Angeles, CA, 90048, USA.
Emma GilletteDivision of Trauma and Critical Care, Department of Surgery, Cedars-Sinai Medical Center, 8635 West 3rd Street, Suite 650 W, Los Angeles, CA, 90048, USA.
Daniel R MarguliesDivision of Trauma and Critical Care, Department of Surgery, Cedars-Sinai Medical Center, 8635 West 3rd Street, Suite 650 W, Los Angeles, CA, 90048, USA.
Eric J LeyDivision of Trauma and Critical Care, Department of Surgery, Cedars-Sinai Medical Center, 8635 West 3rd Street, Suite 650 W, Los Angeles, CA, 90048, USA.
Cedars-Sinai Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionPreventing secondary insult to the brain is imperative following traumatic brain injury (TBI). Although TBI does not preclude nonoperative management (NOM) of splenic injuries, development of hypotension in this setting may be detrimental and could therefore lead trauma surgeons to a lower threshold for operative intervention and a potentially higher risk of failure of NOM (FNOM). We hypothesized that the presence of a TBI in patients with blunt splenic injury would lead to a higher risk of FNOM.

methodsPatients with blunt splenic injury were selected from the National Trauma Data Bank research datasets from 2007 to 2011. TBI was defined as AIS head ≥ 3 and FNOM as patients who underwent a spleen-related operation after 2 h from admission. TBI patients were compared to those without head injury. The primary outcome was FNOM.

resultsOf 47,713 patients identified, 41,436 (86.8%) underwent a trial of NOM. FNOM was identical (10.6 vs. 10.8%, p = 0.601) among patients with and without TBI. TBI patients had lower adjusted odds for FNOM (AOR 0.66, p < 0.001), even among those with a high-grade splenic injury (AOR 0.68, p < 0.001). No difference in adjusted mortality was noted when comparing TBI patients with and without FNOM (AOR 1.01, p = 0.95).

conclusionsNOM of blunt splenic trauma in TBI patients has higher adjusted odds for success. This could be related to interventions targeting prevention of secondary brain injury. Further studies are required to identify those specific practices that lead to a higher success rate of NOM of splenic trauma in TBI patients.

Indexed as

AdolescentAdultAgedBrain Injuries, TraumaticFemaleHospitalizationHumansInjury Severity ScoreLogistic ModelsMaleMiddle AgedRetrospective StudiesSpleenTreatment FailureWounds, NonpenetratingYoung Adult

Identifiers

PMID29387960
OpenAlexW2793195937

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.