Traditional criteria for observation of splenic trauma should be challenged

W. Trevor Gaunt, Mary C. Mccarthy, Carie S. Lambert, Gary L. Anderson, Linda M. Barney, Margaret M. Dunn, Gary Lemmon, Doug B. Paul, James B. Peoples

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Age less than 55 years, normal Glasgow Coma Score (GCS), and absence of hypotension are traditional criteria for the selection of adult patients with blunt splenic trauma for observation. The objective of this study is to challenge these criteria. Two hundred twelve patients who presented with blunt splenic injury between 1992 and 1997 were identified from the Trauma Registry at our Level I trauma center. The patients were divided into three groups: 100 patients (47%) were observed, 108 (51%) underwent immediate splenorrhaphy or splenectomy, and 4 (2%) failed observation. The three groups were compared by participants' ages, GCSs, and histories of hypotension. No statistical differences were noted between the successfully observed patients and those requiring immediate surgery with respect to these criteria. Of the 4 patients who failed observation, all were younger than 55 years, all had a GCS >12, and all were normotensive. Our findings suggest that traditional criteria used to select patients for splenic trauma observation are not absolute indicators and should be liberalized: patients can be successfully observed despite having criteria that, in the past, would have led to immediate operative intervention.

Original languageEnglish (US)
Pages (from-to)689-692
Number of pages4
JournalAmerican Surgeon
Volume65
Issue number7
StatePublished - Jul 1999
Externally publishedYes

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Observation
Wounds and Injuries
Coma
Hypotension
Patient Selection
Nonpenetrating Wounds
Trauma Centers
Splenectomy
Registries

ASJC Scopus subject areas

  • Surgery

Cite this

Gaunt, W. T., Mccarthy, M. C., Lambert, C. S., Anderson, G. L., Barney, L. M., Dunn, M. M., ... Peoples, J. B. (1999). Traditional criteria for observation of splenic trauma should be challenged. American Surgeon, 65(7), 689-692.

Traditional criteria for observation of splenic trauma should be challenged. / Gaunt, W. Trevor; Mccarthy, Mary C.; Lambert, Carie S.; Anderson, Gary L.; Barney, Linda M.; Dunn, Margaret M.; Lemmon, Gary; Paul, Doug B.; Peoples, James B.

In: American Surgeon, Vol. 65, No. 7, 07.1999, p. 689-692.

Research output: Contribution to journalArticle

Gaunt, WT, Mccarthy, MC, Lambert, CS, Anderson, GL, Barney, LM, Dunn, MM, Lemmon, G, Paul, DB & Peoples, JB 1999, 'Traditional criteria for observation of splenic trauma should be challenged', American Surgeon, vol. 65, no. 7, pp. 689-692.
Gaunt WT, Mccarthy MC, Lambert CS, Anderson GL, Barney LM, Dunn MM et al. Traditional criteria for observation of splenic trauma should be challenged. American Surgeon. 1999 Jul;65(7):689-692.
Gaunt, W. Trevor ; Mccarthy, Mary C. ; Lambert, Carie S. ; Anderson, Gary L. ; Barney, Linda M. ; Dunn, Margaret M. ; Lemmon, Gary ; Paul, Doug B. ; Peoples, James B. / Traditional criteria for observation of splenic trauma should be challenged. In: American Surgeon. 1999 ; Vol. 65, No. 7. pp. 689-692.
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