Evidence map›Paper›PMID 38077669›Full record

ArticleCureus2023

A Comparative Study of Operative Versus Non-operative Management of High-Grade Splenic Injuries in a Tertiary Care Center in India.

Pradeep Chandran, Alex Chakiath, Sulfekar Meera Sainaba, Prashant Girijavallabhan Nair, Jayas Siby, Gowri Madhusudanan Pillai, Amjad Ali Khan, Alfin Jose, Deepak Pradeep Kumar, Jerin George Viju

Open access · diamondAbstract read
In one paragraph

Article in Cureus, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
–field-weighted citation impact, top 63% 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

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

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

10 authors at 5 institutions in 4 countries.

Pradeep ChandranTrauma Surgery, King's College Hospital, London, GBR.
Alex ChakiathSurgical Oncology, Malabar Cancer Centre, Thalassery, IND.
Sulfekar Meera SainabaGeneral Surgery, Government Medical College, Thiruvananthapuram, Thiruvananthapuram, IND.
Prashant Girijavallabhan NairGeneral Surgery, Wirral University Teaching Hospital, Liverpool, GBR.
Jayas SibyGeneral Surgery, Whipps Cross Hospital, London, GBR.
Gowri Madhusudanan PillaiGeneral Surgery, West Middlesex University Hospital, London, GBR.
Amjad Ali KhanGeneral Surgery, Daya General Hospital, Thrissur, IND.
Alfin JoseGeneral Surgery, Government Medical College, Thrissur, Thrissur, IND.
Deepak Pradeep KumarGeneral Surgery, Government Medical College, Thiruvananthapuram, Thiruvananthapuram, IND.
Jerin George VijuGeneral Surgery, Government Medical College, Thrissur, Thrissur, IND.
Government Medical College · INMalabar Cancer Centre · INKing's College - North Carolina · USWest Middlesex University Hospital · GBWhipps Cross University Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background The spleen is one of the most common solid organs injured in blunt abdominal trauma with significant mortality. The management of splenic injury has significantly changed over the last few decades, ranging from certain splenectomies to non-operative management (NOM). Although several retrospective studies have been published on the NOM of minor spleen injuries, few studies have analyzed the results of NOM for high-grade splenic injuries. The pertinent question that we attempt to answer is, "Is it possible to manage extensive splenic injuries non-operatively?". Objectives To study the feasibility of NOM for the American Association for the Surgery of Trauma (AAST) Grade 3, 4, and 5 splenic injuries and to assess the demographic profile and cases for AAST Grade 3, 4, and 5 splenic injuries. Methods and methodology We, retrospectively, studied patients admitted with AAST Grade 3, 4, and 5 splenic injuries from blunt abdominal trauma admitted at the Government Medical College, Thiruvananthapuram, India, between January 2014 and October 2020. Their demographics, grade of splenic injuries, associated injuries, and methods of management were collected, and statistical analysis was done. Results The study included 132 patients with AAST Grade 3, 4, and 5 splenic injuries. Fifty percent of patients had Grade 3 injuries, 39.4% had Grade 4 injuries, and 10.6% were found to have Grade 5 splenic injuries. Grade 3 and 4 injuries were mainly managed non-operatively, while Grade 5 injuries had a failure rate of nearly 65% when managed non-operatively. Additionally, 73.5% of splenic injuries were successfully managed non-operatively. A significant association was noted between the severity of injuries and the need for operative management (p<0.001). Meanwhile, 64.29% of the patients with Grade 5 splenic injuries ended up needing operative management, as opposed to 34.62% in Grade 4 and 12.12% in Grade 3 splenic injuries. Conclusion We suggest that NOM may be undertaken successfully in appropriately designed areas with close observation for hemodynamically stable patients with extra vigilance in the case of the elderly and those with associated injuries. There should be a low threshold for switching to operative management, especially in Grade 5 injuries.

Indexed as

blunt abdomen traumablunt abdominal injuryhaemoperitoneumnomsplenic trauma

Identifiers

PMID38077669
PMCPMC10702254
OpenAlexW4389394596

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LicenceCC BY
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Registered trials

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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.