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  1. Delayed complications of nonoperative management of blunt adult splenic trauma. Discussion.

    Article - En anglais

    Objective 

    To determine the incidence and type of delayed complications from nonoperative management of adult splenic injury.

    Design 

    Retrospective medical record review.

    Setting 

    University teaching hospital, level I trauma center.

    Patients 

    Two hundred eighty patients were admitted to the adult trauma service with blunt splenic injury during a 4-year period.

    Men constituted 66% of the population.

    The mean (±SEM) age was 32.2±1.0 years and the mean (±SEM) Injury Severity Score was 22.8±0.9. Fifty-nine patients (21%) died of multiple injuries within 48 hours and were eliminated from the study.

    One hundred thirty-four patients (48%) were treated operatively within the first 48 hours after injury and 87 patients (31%) were managed nonoperatively.

    Main Outcome Measures 

    We reviewed the number of units of blood transfused, intensive care unit length of stay, overall length of stay, outcome, and complications occurring more than 48 hours after injury directly attributable to the splenic injury.

    Results 

    Patients managed nonoperatively had a significantly lower Injury Severity Score (P<. 05) than patients treated operatively.

    Length of stay was significantly decreased in both the number of intensive care unit days as well as total length of stay (P<. 05).

    The number of units of blood transfused was also significantly decreased in patients managed nonoperatively (P<. 05).

    Seven patients (8%) managed nonoperatively developed delayed complications requiring intervention. (...)

    Mots-clés Pascal : Traumatisme, Rate, Surveillance, Unité soin intensif, Adulte, Homme, Traitement, Epidémiologie, Incidence, Complication, Temps différé, Abdomen pathologie, Rate pathologie, Réanimation

    Mots-clés Pascal anglais : Trauma, Spleen, Surveillance, Intensive care unit, Adult, Human, Treatment, Epidemiology, Incidence, Complication, Delayed time, Abdominal disease, Splenic disease, Resuscitation

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0300919

    Code Inist : 002B16G. Création : 27/11/1998.