Treatment of Splenic Trauma: a Retrospective Cohort Study

Study Overview
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Brief Summary
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In blunt trauma, the spleen is most frequent injured organ in the abdomen and the most frequent source of bleeding in the abdomen. Historically, splenectomy was the treatment of choice for splenic bleeding. For exsanguinating patients, open splenectomy is still the proper choice of treatment if the spleen is a significant source of bleeding. However, for hemodynamic stable patients with splenic injury, non-operative management (NOM) is an alternative, assuming they have no other indication for surgery (peritonitis). Non-operative management includes observation and/or splenic artery embolisation (SAE), but the indications for observation and SAE varies between trauma centers. The greatest advantage of NOM is the preservation of splenic function. In the investigators hospital splenic artery embolisation was introduced in 2007. The investigators want to describe the treatment of splenic injuries in their hospital, to see if the number of splenectomies has been recduced after 2007, and to see if SAE has also been used in transferred trauma patients.

Official Title
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Treatment of Splenic Trauma: a Retrospective Cohort Study

Conditions
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Splenic Injury

Intervention / Treatment
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* Procedure: Treatment of splenic injury


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All patients admitted at UNN Tromsø in the period of 01.01.2000 - 31.12.2013 and with the discharge diagnosis S36.0 Splenic injury (ICD-10) Exclusion Criteria: no injury/coding error iatrogenic injury transfer >7 days after injury >10 days between injury and first hospital admission
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Splenic injury<br>All patients admitted at the University Hospital North Norway Tromsø with a splenic injury following trauma, are included in the study. | Procedure: Treatment of splenic injury<br>* There are four possible treatments of splenic injury in this study: splenectomy splenic artery embolisation non-operative management any combination of the three treatments mentioned<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| type of splenic trauma treatment | There are three different treatments of splenic trauma treatment, resulting in four different treatments: splenectomy splenic artery embolization non-operative management any combination of the three treatments | 0-7 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Mortality |  | 30 days | 
| Length of hospital stay |  | 1 - 90 days | 
| Length of stay in the intensive care unit |  | 0 - 90 days | 
| Emergency procedures | Emergency procedures includes: Chest tube insertion Hemostatic surgery in the abdomen Hemostatic surgery in the pelvis with packing Thoracotomy Primary stabilization of fractures (external fixation) Endotracheal intubation | 0 - 7 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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spleen, injury, patient transfer, splenectomy, embolization, theurapeutic