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Research trends in pediatric splenic trauma in Brazil: how much has changed in the last two decades?
Luiza Telles1, Ayla Gerk2,3,4, Ana Maria Diniz5
1Estácio - Instituto de Educação Médica - Rio de Janeiro (RJ) - Brazil.
Insights
Pediatric spleen trauma research is scarce in Brazil compared to the USA. Brazilian studies show a high rate of splenectomy for spleen injuries in children, unlike in high-income countries.
Area of Science:
- Pediatric Surgery
- Trauma Management
- Global Health Disparities
Background:
- Non-operative management of pediatric spleen injuries is well-documented in high-income countries, with low splenectomy rates (5%).
- Limited research exists on pediatric spleen trauma in low- and middle-income countries (LMICs), such as Brazil.
Purpose of the Study:
- To analyze and compare research trends in pediatric spleen trauma between Brazil and the United States of America (USA).
- To identify research gaps in pediatric splenic trauma management in LMICs.
Main Methods:
- A comprehensive scoping review of five databases was conducted.
- Articles published between 1968 and 2023 in English or Portuguese, focusing on pediatric spleen injury in Brazil and the USA, were included.
- Independent reviewers screened titles, abstracts, and full texts.
Main Results:
- A total of 7,150 studies were identified, with 295 eligible for data extraction.
- The USA dominated the literature (98.64%), while Brazil contributed only 1.36% (4 studies).
- Splenectomy rates for pediatric spleen injury were significantly higher in Brazilian studies (98.57%) compared to US studies (11.33%).
Conclusions:
- Brazil has a substantial deficit in published research on pediatric splenic trauma.
- Future research should focus on the incidence and management of spleen injuries in children within LMICs.
- Significant disparities exist in the research output and clinical management of pediatric spleen trauma between Brazil and the USA.
Purpose:
Research in high-income countries has extensively documented the non-operative management of spleen injuries in children, resulting in low splenectomy rates (5%). However, there is a lack of literature on this topic in low- and-middle-income countries (LMICs), including Brazil. This scoping review analyzed pediatric spleen trauma research trends in Brazil and the United States of America (USA).
Methods:
Search strategy was conducted across five databases, considering articles published in English or Portuguese from January 1968 to 2023 that reported spleen injury in patients younger than 18 years old in Brazil or the USA. Two pairs of independent reviewers screened the title and the abstract, followed by a full-text review.
Results:
The total of 7,150 studies was identified, of which 295 were eligible for data extraction. Most papers (98.64%, 301) originated from the USA, while only 1.36% (4) were from Brazil. In addition, 46.44% (137) articles reported intrabdominal injury, including splenic trauma, 16.27% (48) liver and spleen injury, and 37.29% (110) reported isolated spleen injury. The operative rate for spleen injury was 11.33% in American studies (40,812/359,926) compared to 98.57% (137/139) in Brazilian studies.
Conclusions:
Brazil contributed only with four studies on pediatric splenic trauma over two decades. Future studies should explore the incidence and management of splenic trauma in LMICs.
