SPLENIC ARTERY EMBOLIZATION VERSUS SPLENECTOMY: ANALYSIS FOR EARLY IN-HOSPITAL INFECTIOUS COMPLICATIONS AND OUTCOMES.

Background: Splenic artery embolization has gained increasing acceptance as an important adjunct in the treatment of splenic injuries. Residual immunologic function of the spleen after embolization and its consequences on early infectious complications still remain intensely debated. The purpose of this study was to compare splenic artery embolization and splenectomy in terms of early in-hospital infectious complications and outcomes. Methods: Two year retrospective Trauma Quality Improvement Program (TQIP) database prognostic study. Patients with grade IV-V splenic injury requiring splenic artery embolization or splenectomy were included in the final analysis. Examined variables were demographics, mechanism of injury, Abbreviated Injury Scale (AIS), Injury Severity Score (ISS), Organ Injury Scale (OIS), admission vital signs, blood transfusion in the first 24 hours, early infectious complications, and outcomes. Multivariate analysis adjusted for patient and injury-related variables was used to identify independent predictors for infectious complication and mortality. Results: During the study period, 4,063 patients with a grade IV-V splenic injury managed with Splenic Artery Embolization (SAE) or Splenectomy (SP) were included in the study. SAE was performed in 461 patients (11.3%). The early infectious complication rate was 23.1% in the SP group and 11.7% in the SAE group (p=65 years old, GCS =3, splenectomy, and blood transfusion in the first 24 hours as independent predictors for early infectious complications. The unadjusted overall mortality was 12.7% in the SP group and 5.4% in the SAE group (p=65, GCS =3, and blood transfusion in the first 24 hours were independent risk factor for mortality. Splenectomy was not an independent risk factor in terms of mortality. Subgroup analysis in patients with isolated splenic injury showed age >=65, GCS

from Emergency Medicine via xlomafota13 on Inoreader http://ift.tt/2pAtLd9