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Trial reportEmergency radiology2024

Patient factors associated with embolization or splenectomy within 30 days of initiating surveillance for splenic trauma.

Fatah Tidadini, Eugenie Martinet, Jean-Louis Quesada, Alison Foote, Chayma El Wafir, Edouard Girard, Catherine Arvieux, SPLASH study group

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Emergency radiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02021396 (Benefit of Prophylactic Embolization of the Splenic Salvage in Trauma Patients at High Risk of Splenectomy.), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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.

NCT02021396 nacompletednot on this map

Benefit of Prophylactic Embolization of the Splenic Salvage in Trauma Patients at High Risk of Splenectomy.

TypeinterventionalSponsorUniversity Hospital, GrenobleRan2014 to 2018Enrolled140ConditionsSplenic TraumaArmsEmbolization
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
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.

Fatah TidadiniDepartment of Digestive and Emergency Surgery, Grenoble Alpes University Hospital (CHU), Grenoble, 38043, France. FTidadini@chu-grenoble.fr.
Eugenie MartinetDepartment of Digestive and Emergency Surgery, Grenoble Alpes University Hospital (CHU), Grenoble, 38043, France.
Jean-Louis QuesadaDepartment of Digestive and Emergency Surgery, Grenoble Alpes University Hospital (CHU), Grenoble, 38043, France.
Alison FooteDepartment of Digestive and Emergency Surgery, Grenoble Alpes University Hospital (CHU), Grenoble, 38043, France.
Chayma El WafirDepartment of Digestive and Emergency Surgery, Grenoble Alpes University Hospital (CHU), Grenoble, 38043, France.
Edouard GirardDepartment of digestive surgery, Univ. Grenoble Alpes, CNRS, CHU Grenoble Alpes, Grenoble INP, TIMC, Grenoble, 38000, France.
Catherine ArvieuxDepartment of digestive surgery, Univ. Grenoble Alpes, CNRS, CHU Grenoble Alpes, Grenoble INP, TIMC, Grenoble, 38000, France. carvieux@chu-grenoble.fr.
SPLASH study group

Funding

French Ministry of Health, Hospital clinical research program (PHRC) 2012 French Ministry of Health, Hospital clinical research program (PHRC) 2012
6 · The paper itself

Abstract

backgroundNon-operative management of hemodynamically stable patients with splenic trauma has been recommended for more than 25 years, but in practice embolization and/or splenectomy (intervention) is often needed within the first 30 days. Identifying the risk factors associated with the need for intervention could support more individualized decision-making.

methodsWe used data from the SPLASH randomized clinical trial, a comparison of outcomes of surveillance or embolization. 140 patients were randomized, 133 retained in the study (embolization n = 66; surveillance n = 67) and 103 screened and registered in the non-inclusion register. Multivariate Cox proportional hazards models with time-varying covariates were used to identify risk factors contributing to embolization and/or splenectomy within 30 days after initiating surveillance only for splenic trauma.

results123 patients (median age, 30 [23; 48] years; 91 (74%) male) initially received non-operative management. At the day-30 visit, 34 (27.6%) patients had undergone an intervention (31 (25.2%) delayed embolization and 4 (3.3%) splenectomy). Multivariate analysis identified patients with OIS grade 4 or 5 splenic trauma (HR = 4.51 [2.06-9.88]) and (HR = 34.5 [6.84-174]); respectively) and splenic complications: arterial leak (HR = 1.80 [1.45-2.24]), pseudoaneurysm (HR = 1.22 [1.06-1.40]) and pseudocyst (HR = 1.41 [1.21-1.64]) to be independently associated with increased risk of need for an intervention within 30 days of initiating surveillance.

conclusionsOur study shows that more than 1 in 4 patients who received non-operative management needed embolization or splenectomy by day 30. Arterial leak, pseudoaneurysm, pseudocyst, and OIS grade 4 or 5 were independent risk factors linked to the need for an intervention.

trial registrationclinicaltrials.gov Identifier NCT02021396.

Indexed as

Embolization, TherapeuticSpleenSplenectomyAdultFemaleHumansMaleMiddle AgedRisk FactorsEmbolizationRisk factorsSplenectomySplenic traumaSurveillance

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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.