Impact of Treatment Modalities on Discharge Disposition in Blunt Splenic Injuries

Area of Science:

• Trauma Surgery
• Surgical Outcomes
• Patient Disposition

Background:

• Blunt splenic trauma management trends towards nonoperative approaches and splenic artery embolization.
• Limited data exists on treatment modality's association with discharge disposition for blunt splenic injuries.

Purpose of the Study:

• To investigate factors associated with unfavorable discharge in adult blunt splenic trauma patients.
• To identify predictors of discharge disposition following blunt splenic injury.

Main Methods:

• Observational retrospective study of 579 adult patients with blunt splenic trauma (January 2010 - December 2021).
• Unfavorable discharge defined as transfer to an acute care, intermediate care, long-term care, inpatient rehabilitation, or skilled nursing facility.
• Treatment modalities categorized as intervention (embolization, splenectomy) and nonintervention.

Main Results:

• 18.7% of patients experienced unfavorable discharge.
• Nonoperative management was most common (69.3%), followed by splenectomy (25.0%) and embolization (5.7%).
• Treatment modality did not significantly impact discharge disposition. Independent risk factors for unfavorable discharge included age >55, Injury Severity Score (ISS) >15, hospital-acquired pneumonia, and sepsis.

Conclusions:

• Identifies demographic and clinical factors predicting unfavorable discharge in blunt splenic trauma.
• Highlights the importance of managing in-hospital complications like pneumonia and sepsis.
• Data can guide providers in identifying and managing at-risk patients to improve discharge outcomes.