Document Type : Original Article

Authors

1 Assistant Professor of Surgical Oncology, Department of Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

3 Assistant Professor of Surgery, Department of Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.

10.30476/beat.2024.101350.1489

Abstract

Backgrounds and aims: Considering the immunological function of the spleen, the complications, and the risk of infections and thrombocytosis following splenectomy, today's efforts are more towards preserving the spleen instead of splenectomy in splenic injury. This study aimed to evaluate the outcome and risk factors in operative and non-operative management of splenic injury.

Methods: This retrospective study was conducted on traumatic splenic injury patients hospitalized in Isfahan's Kashani hospital from 2017 to 2019. Studied variables were extracted from medical records of enrolled participants. Outcome (mortality and complications) and risk factors were compared based on treatment methods.

Results: A total of 240 patients were investigated. The mean (SD) age of the patients was 29.8 (12.2), and 180 (77.5%) were men. 154 (64.2%) patients underwent operative treatment. Mortality rate was 18.9% and 4.6% among operative and non-operative groups (P<0.001). Complications were observed in 11.5% and 46.1% of non-operative and operative groups (P<0.001). Operative treatment inversely correlated with mortality (P<0.001) and complications (P<0.05). Splenic injury severity correlated positively with mortality (P<0.001) and negatively with complications (P<0.001). Unstable hemodynamic status was positively correlated with complications (P<0.001). Age had a positive correlation with mortality (P<0.001) and complications (P<0.001). Male sex was inversely correlated with complications (P<0.001). GCS score and on admission was positively correlated with mortality (P<0.001). No statistically significant correlation was found between associated injuries and outcome (P≥0.05).

Conclusion: Rates of mortality and complications were higher among patients who underwent surgery; however, considering the role of confounders, operative treatment was inversely associated with mortality and complications.

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