Background: PURPOSE: To compare the treatment and outcomes of blunt splenic injury (BSI) management strategy within Major Trauma centres in England between 2017 and 2022.
Methods: Data was extracted from UK TARN (Trauma Audit Research Network) identifying all splenic injuries admitted to English Major Trauma Centres (MTCs) between 01/01/17 and 31/12/21. Mechanism, injuries, treatment and outcomes were compared between management strategies according to American Association of Surgery in Trauma (AAST) grade over the period. The main endpoints of splenic salvage rate, along with mortality and length of stay were compared between the treatment options.
Results: 3,723 patients sustained BSI; 2,906 (78.1%) were managed conservatively, 491 (13.2%) underwent embolisation while 326 (8.8%) underwent splenectomy. There were 1895 (50.9%) AAST grade 2 injuries, 1019 (27.4%) grade 3, 592 (15.9%) grade 4 and 247 (6.6%) grade 5. Embolisation was successful (i.e. no subsequent splenectomy) for 465/491 (94.7%). The length of stay of discharged patients in the splenectomy group was longer than in those receiving embolisation (p = 0.001) or conservative management (p < 0.001) (median (IQR) of 12 (7, 27), 10 (6, 19), 10 (6, 20) days, respectively). Mortality at 30 days was not significantly different in those who underwent splenectomy (12.3%) compared to embolisation (8.6%) and conservative management (11.5%) (p = 0.129).
Conclusion: Splenic embolisation results in a high rate of splenic salvage.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00270-024-03896-6 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
The history and development of Irish orthopaedics: a descriptive review.
Ir J Med Sci
December 2024
Royal College of Surgeons in Ireland, Dublin, Ireland.
From'grave diggers' to a 'Trauma System for Ireland', the history of Irish orthopaedics is a unique and fascinating story. This story has developed over decades and centuries, with many late and great surgeons and trainers playing major roles in developing our orthopaedic services nationally, as we know them today. The authors acknowledge that it would be wrong to think that a 1500-word review could provide an in-depth, yet comprehensive, discussion of all topics past and present of celebration, deliberation and further debate, related to orthopaedic surgery in Ireland.
View Article and Find Full Text PDFPerspectives of current and future use of electrical stimulation home-devices from people with spinal cord injuries and healthcare professionals.
Disabil Rehabil
December 2024
Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Ultimo, Australia.
Introduction: Electrical stimulation (E-stim) can reduce the impact of complications, like spasticity, bladder dysfunction in people with spinal cord injuries (SCIs), enhancing quality of life and health outcomes. With SCI prevalence high in regional Australia and a shift towards home-based community integrated care, the perspectives of people with SCI and healthcare professionals on current and future use of E-stim home-devices are needed.
Methods: A mixed-methods concurrent triangulation approach was used.
[Results of clinical and immunomorphological analysis in chronic post-traumatic uveitis].
Vestn Oftalmol
December 2024
AO Meditsina (Academician Roytberg's Clinic), Moscow, Russia.
Purpose: This study was conducted to identify the group at highest risk for autoimmune inflammation through a comparative analysis among patients with chronic post-traumatic uveitis (CPTU).
Material And Methods: The clinical group included 50 patients (aged 18 to 87 years, mean age 41±2.6 years) with CPTU resulting from penetrating injury, contusion, or intraocular surgery.
Helicopter emergency medical services demonstrate reduced time to emergency anaesthesia in an undifferentiated trauma population: a retrospective observational analysis across three major trauma networks.
Scand J Trauma Resusc Emerg Med
December 2024
Air Ambulance Charity Kent Surrey Sussex, Redhill Aerodrome, Redhill, Surrey, RH1 5YP, UK.
Background: Early rapid sequence induction of anaesthesia (RSI) and tracheal intubation for patients with airway or ventilatory compromise following major trauma is recommended, with guidance suggesting a 45-min timeframe. Whilst on-scene RSI is recommended, the potential time benefit offered by Helicopter Emergency Medical Services (HEMS) has not been studied. We compared the time from 999/112 emergency call to delivery of RSI between patients intubated either in the Emergency Department or pre-hospital by HEMS.
View Article and Find Full Text PDFCopper-coordination driven brain-targeting nanoassembly for efficient glioblastoma multiforme immunotherapy by cuproptosis-mediated tumor immune microenvironment reprogramming.
J Nanobiotechnology
December 2024
Key Laboratory of Emergency and Trauma of Ministry of Education, Engineering Research Center for Hainan Biological Sample Resources of Major Diseases, the Hainan Branch of National Clinical Research Center for Cancer, the First Affiliated Hospital, Hainan Medical University, Haikou, 570102, China.
Limited drug accumulation and an immunosuppressive microenvironment are the major bottlenecks in the treatment of glioblastoma multiforme (GBM). Herein, we report a copper-coordination driven brain-targeting nanoassembly (TCe6@Cu/TP5 NPs) for site-specific delivery of therapeutic agents and efficient immunotherapy by activating the cGAS-STING pathway and downregulating the expression of PD-L1. To achieve this, the mitochondria-targeting triphenylphosphorus (TPP) was linked to photosensitizer Chlorin e6 (Ce6) to form TPP-Ce6 (TCe6), which was then self-assembled with copper ions and thymopentin (TP5) to obtain TCe6@Cu/TP5 NPs.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!