Severe Splenic Injuries in Patients With Multiple Trauma
Authors' conclusion
This study found that splenic salvage in patients with multiple trauma was associated with decreased mortality, fewer complications, and shorter hospital course compared with splenectomy.
Study context
- Population
- Adults with multiple trauma and severe blunt splenic injuries, ACS Trauma Quality Improvement Program database, January 2017 to December 2022
- Participants
- 12,930 adults
- Exposure
- Splenic angioembolization or observation vs open splenectomy
- Open splenectomy (OS)n = 3,390reference
- Splenic angioembolization (SAE)n = 2,537
- Observation (OBS)n = 7,003
- Outcome
- In-hospital mortality
Methodological detailsmultivariable regression, registry database (ACS TQIP), sensitivity analysis
- Multivariable regression
- Registry database (ACS TQIP)
- Sensitivity analysis
Main finding
As reported in the abstract
Each group vs OSHazard ratio (95% CI)P value
SAE
0.62(0.49–0.80)
P < 0.001OBS
0.61(0.50–0.74)
P < 0.001Observational data: associations, not effects.
Secondary outcomes
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Complications, failed NOM vs upfront OS (subgroup)Failed NOM vs Upfront OS | 3.09 (2.22–4.30) | P < 0.001 | |
| Complications, failed NOM vs upfront OS (subgroup)Failed NOM vs Upfront OS · second of two reported ORs ('respectively') | 1.46 (1.21–1.76) | P < 0.001 | |
| 0.20.5125Odds ratio (log scale) |
| Outcome | β (95% CI) | P value |
|---|---|---|
| Hospital LOSSAE vs OS | −1.37 (−2.03 to −0.71) | P < 0.001 |
| Hospital LOSOBS vs OS | −1.33 (−1.93 to −0.74) | P < 0.001 |
| ICU LOSSAE vs OS | −1.42 (−1.87 to −0.96) | P < 0.001 |
| ICU LOSOBS vs OS | −1.34 (−1.75 to −0.92) | P < 0.001 |
Hypotensive patients (subgroup)
- No increase in mortality, complications, or hospital course
Safety
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| ComplicationsSAE vs OS | 0.74 (0.64–0.86) | P < 0.001 | |
| ComplicationsOBS vs OS | 0.75 (0.66–0.85) | P < 0.001 | |
| 0.512Odds ratio (log scale) |
Complications
- OS had more acute respiratory distress syndrome (ARDS), cardiac arrest, and severe sepsis
Original publication
Severe Splenic Injuries in Patients With Multiple Trauma. JAMA Surg. Published 1 April 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →