Postdischarge complications following nonoperative management of blunt splenic injury.

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  • Additional Information
    • Source:
      Publisher: Excerpta Medica Country of Publication: United States NLM ID: 0370473 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-1883 (Electronic) Linking ISSN: 00029610 NLM ISO Abbreviation: Am J Surg Subsets: MEDLINE
    • Publication Information:
      Publication: Belle Mead, NJ : Excerpta Medica
      Original Publication: New York.
    • Subject Terms:
      Abdominal Injuries/*complications ; Abdominal Injuries/*therapy ; Spleen/*injuries ; Wounds, Nonpenetrating/*complications ; Wounds, Nonpenetrating/*therapy; Abdominal Injuries/surgery ; Adolescent ; Adult ; California ; Female ; Humans ; Male ; Middle Aged ; Patient Discharge ; Patient Readmission/statistics & numerical data ; Risk Factors ; Time Factors ; Wounds, Nonpenetrating/surgery
    • Abstract:
      Background: Nonoperative management (NOM) is the standard of care in majority of blunt splenic injuries. However, little is known about the postdischarge complications.
      Methods: Patients admitted for blunt splenic injury were identified in the California State Inpatient Database (2007 to 2011). We examined patterns and risk factors for postdischarge complications among these patients.
      Results: In total, 2,704 (61.45%) patients had NOM without splenic artery embolization (SAE) and 257 (5.84%) had NOM with adjunct SAE. Thirty-day readmission rate was higher in those who had adjunct SAE (12.84% vs 7.36%, P = .002). Subsequent operations during readmission were seen in 18.10% of readmitted patients and 38.10% of all patients were readmitted at nonindex hospitals. Major diagnoses on readmission were spleen injury (36.2%) and respiratory complications (9.05%). Adjunct SAE was an independent risk factor for readmission (adjusted odds ratio 1.82, 95% confidence interval 1.19 to 2.78).
      Conclusions: Nearly one fifth of readmitted patients initially managed nonoperatively required an operative intervention. Improving predischarge assessments and postdischarge follow-up may reduce readmissions among these patients.
      (Copyright © 2016 Elsevier Inc. All rights reserved.)
    • Comments:
      Erratum in: Am J Surg. 2018 Jul;216(1):186-187. (PMID: 28468726)
    • Contributed Indexing:
      Keywords: Abdominal injury; Nonoperative management; Readmission; Risk factors; Splenic injury; Trauma
    • Publication Date:
      Date Created: 20160203 Date Completed: 20160725 Latest Revision: 20220311
    • Publication Date:
      20231215
    • Accession Number:
      10.1016/j.amjsurg.2015.11.018
    • Accession Number:
      26830714