A clinical prediction model for non-operative management failure in patients with high-grade blunt splenic injury

Shokei Matsumoto, Makoto Aoki, Masayuki Shimizu, Tomohiro Funabiki

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Nonoperative management (NOM) is the standard treatment for hemodynamically stable blunt splenic injury (BSI). However, NOM failure is a significant source of morbidity and mortality. We developed a clinical risk scoring system for NOM failure in BSI. Methods: Data from the Japanese Trauma Data Bank from 2008 to 2018 were analyzed. Eligible patients were restricted to those who underwent NOM with high-grade BSI (Organ Injury Scale ≥3). The primary outcome was a predictive score for NOM failure based on risk estimation. Results: There were 1651 patients included in this analysis, among whom 110 (6.7%) patients had NOM failure. Multivariate analysis identified seven variables associated with failed NOM: systolic blood pressure, Glasgow coma scale, Injury Severity Score, other concomitant abdominal injury, pelvic injury, high-grade BSI, and angioembolization. An eight-point predictive score was developed with a cut-off of greater than 5 points (specificity, 98.2%; sensitivity, 25.5%) with an area under the curve of 0.81. Conclusion: The clinical predictive score had good ability to predict NOM failure and may help surgeons to make better decisions for BSI.

Original languageEnglish
Article numbere20537
JournalHeliyon
Volume9
Issue number10
DOIs
Publication statusPublished - 10-2023

All Science Journal Classification (ASJC) codes

  • General

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