ISSN: 0970-938X (Print) | 0976-1683 (Electronic)

Biomedical Research

An International Journal of Medical Sciences

Abstract

Attempt to identify selection criteria for surgical management of splenic injury

Outcome of the management of blunt splenic injuries over a 9-year period was exam-ined in the present study. A retrospective chart review of 61 patients above the age of twelve admitted into the hospital with splenic injuries from May 1994 to May 2003 in Aseer Central Hospital, Abha, Kingdom of Saudi Arabia (A level II regional trauma centre). The outcome measures include complications during management and mortal-ity. Detailed analyses were carried out using the student t test, chi-square test, and means, regression analysis. Splenectomy was performed in 58 cases (95.1%) while the splenic injuries were managed non-operatively in 3 cases (4.9%) all of whom survived. The mean duration of hospital stay was 18.8 ± 21.31 days (Range = 1-123 days). The overall mortality rate was 23%, with a mortality rate of 7% seen in the correlation with infectious morbidity (all P < 0.05).The overall mean Injury Severity Score (ISS) was 37.6. ISS score was significantly higher in those who died and those who had serious infectious complications compared to those with unremarkable recovery (56.8 and 39.2 vs. 32.4; p=0.04). Linear regression analysis revealed the presence of shock on arrival, an ISS >25, associated head and chest injuries were the most significant factors for prolonged hospital stay. Careful identifications of patients who might benefit form the surgery is required and ISS might be helpful.

Author(s): Mohammed Al-Qahtani
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