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The incidence of delayed splenic bleeding in pediatric blunt trauma.
- Source :
-
Journal of pediatric surgery [J Pediatr Surg] 2018 Feb; Vol. 53 (2), pp. 339-343. Date of Electronic Publication: 2017 Oct 08. - Publication Year :
- 2018
-
Abstract
- Background: One of the concerns associated with nonoperative management of splenic injury in children has been delayed splenic bleed (DSB) after a period of hemostasis. This study evaluates the incidence of DSB from a multicenter 3-year prospective study of blunt splenic injuries (BSI).<br />Methods: A 3-year prospective study was done to evaluate nonoperative management of pediatric (≤18years) BSI presenting to one of 10 pediatric trauma centers. Patients were tracked at 14 and 60days. Descriptive statistics were used to summarize patient and injury characteristics.<br />Results: During the study period, 508 children presented with BSI. Median age was 11.6 [IQR: 7.0, 14.8]; median splenic injury grade was 3 [IQR: 2, 4]. Nonoperative management was successful in 466 (92%) with 18 (3.5%) patients undergoing splenectomy at the index admission, all within 3h of injury. No patient developed a delayed splenic bleed. At least one follow-up visit was available for 372 (73%) patients.<br />Conclusion: A prior single institution study suggested that the incidence of DSB was 0.33%. Based on our results, we believe that the rate may be less than 0.2%.<br />Level of Evidence: Level II, Prognosis.<br /> (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Child
Child, Preschool
Female
Follow-Up Studies
Hemorrhage epidemiology
Humans
Incidence
Infant
Infant, Newborn
Male
Prognosis
Prospective Studies
Splenectomy statistics & numerical data
Splenic Diseases epidemiology
Trauma Centers statistics & numerical data
Treatment Outcome
Wounds, Nonpenetrating diagnosis
Wounds, Nonpenetrating therapy
Hemorrhage etiology
Spleen injuries
Splenic Diseases etiology
Wounds, Nonpenetrating complications
Subjects
Details
- Language :
- English
- ISSN :
- 1531-5037
- Volume :
- 53
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of pediatric surgery
- Publication Type :
- Academic Journal
- Accession number :
- 29079311
- Full Text :
- https://doi.org/10.1016/j.jpedsurg.2017.10.005