The incidence of delayed splenic bleeding in pediatric blunt trauma

David M. Notrica, Lois W. Sayrs, Amina Bhatia, Robert W. Letton, Adam Alder, Shawn St. Peter, Todd A. Ponsky, James Eubanks, Karla A. Lawson, Daniel J. Ostlie, David W. Tuggle, Nilda M. Garcia, R. Todd Maxson, Charles Leys, Cynthia Greenwell

Research output: Contribution to journalArticle

2 Citations (Scopus)

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). Methods: A 3-year prospective study was done to evaluate nonoperative management of pediatric (≤ 18 years) BSI presenting to one of 10 pediatric trauma centers. Patients were tracked at 14 and 60 days. Descriptive statistics were used to summarize patient and injury characteristics. 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 3 h of injury. No patient developed a delayed splenic bleed. At least one follow-up visit was available for 372 (73%) patients. 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%. Level of evidence: Level II, Prognosis.

Original languageEnglish (US)
Pages (from-to)339-343
Number of pages5
JournalJournal of pediatric surgery
Volume53
Issue number2
DOIs
StatePublished - Feb 1 2018

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Nonpenetrating Wounds
Pediatrics
Hemorrhage
Incidence
Wounds and Injuries
Cohort Studies
Prospective Studies
Trauma Centers
Splenectomy
Hemostasis

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

Notrica, D. M., Sayrs, L. W., Bhatia, A., Letton, R. W., Alder, A., St. Peter, S., ... Greenwell, C. (2018). The incidence of delayed splenic bleeding in pediatric blunt trauma. Journal of pediatric surgery, 53(2), 339-343. https://doi.org/10.1016/j.jpedsurg.2017.10.005

The incidence of delayed splenic bleeding in pediatric blunt trauma. / Notrica, David M.; Sayrs, Lois W.; Bhatia, Amina; Letton, Robert W.; Alder, Adam; St. Peter, Shawn; Ponsky, Todd A.; Eubanks, James; Lawson, Karla A.; Ostlie, Daniel J.; Tuggle, David W.; Garcia, Nilda M.; Maxson, R. Todd; Leys, Charles; Greenwell, Cynthia.

In: Journal of pediatric surgery, Vol. 53, No. 2, 01.02.2018, p. 339-343.

Research output: Contribution to journalArticle

Notrica, DM, Sayrs, LW, Bhatia, A, Letton, RW, Alder, A, St. Peter, S, Ponsky, TA, Eubanks, J, Lawson, KA, Ostlie, DJ, Tuggle, DW, Garcia, NM, Maxson, RT, Leys, C & Greenwell, C 2018, 'The incidence of delayed splenic bleeding in pediatric blunt trauma', Journal of pediatric surgery, vol. 53, no. 2, pp. 339-343. https://doi.org/10.1016/j.jpedsurg.2017.10.005
Notrica DM, Sayrs LW, Bhatia A, Letton RW, Alder A, St. Peter S et al. The incidence of delayed splenic bleeding in pediatric blunt trauma. Journal of pediatric surgery. 2018 Feb 1;53(2):339-343. https://doi.org/10.1016/j.jpedsurg.2017.10.005
Notrica, David M. ; Sayrs, Lois W. ; Bhatia, Amina ; Letton, Robert W. ; Alder, Adam ; St. Peter, Shawn ; Ponsky, Todd A. ; Eubanks, James ; Lawson, Karla A. ; Ostlie, Daniel J. ; Tuggle, David W. ; Garcia, Nilda M. ; Maxson, R. Todd ; Leys, Charles ; Greenwell, Cynthia. / The incidence of delayed splenic bleeding in pediatric blunt trauma. In: Journal of pediatric surgery. 2018 ; Vol. 53, No. 2. pp. 339-343.
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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). Methods: A 3-year prospective study was done to evaluate nonoperative management of pediatric (≤ 18 years) BSI presenting to one of 10 pediatric trauma centers. Patients were tracked at 14 and 60 days. Descriptive statistics were used to summarize patient and injury characteristics. 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 3 h of injury. No patient developed a delayed splenic bleed. At least one follow-up visit was available for 372 (73{\%}) patients. 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{\%}. Level of evidence: Level II, Prognosis.",
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