ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2019
Successful non-operative management of haemodynamically unstable traumatic splenic injuries: 4-year case series in a UK major trauma centre.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Splenic Artery Embolisation for Splenic Injury in Haemodynamically Unstable Patients.Cardiovascular and interventional radiology · 2025Article
- Angioembolization for splenic injuries: does it help? Retrospective evaluation of grade III-V splenic injuries at two level I trauma centers.Trauma surgery & acute care open · 2024Article
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Authors and funding
4 authors.
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Abstract
purposeManagement of traumatic splenic injury may be operative or non-operative (including embolization and conservative management). Traditionally, haemodynamic instability has been an indication for operative intervention. We aimed to report our experience of managing traumatic splenic injury at a regional major trauma centre in the UK over a 4-year period, with a particular focus on the non-operative management (NOM) of haemodynamically unstable patients.
methodsAll patients with splenic injuries admitted to North Bristol NHS Trust from April 2012 to March 2016 were included. Patients were classified for analyses by injury severity (low or high grade), haemodynamic instability (defined as a reverse shock index < 1) and management category (operative or non-operative).
results106 patients were included. Overall 85.8% of patients received NOM: 79.2% conservative and 6.6% interventional radiology. Two patients (2.4%) managed conservatively required further intervention. Haemodynamically stable and unstable patients were equally likely to receive NOM (89.7 and 81.3% respectively, p = 1). All unstable patients with low-grade injuries were managed conservatively and only one (2.7%) required further intervention. Two unstable patients with high-grade injuries (28.6%) underwent NOM successfully.
conclusionsThese data support the safe application of non-operative management to haemodynamically unstable patients with traumatic splenic injury, particularly in those with low-grade injuries. Additional prospective work is required to define the subgroup of patients for whom this is appropriate and to determine the long-term outcomes of NOM.
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