Surgical Treatment versus Conservative Management of Splenic Rupture: Outcomes and Risk Factors.

OBJECTIVE: This study aimed to evaluate the outcome and risk factors in operative and non-operative management of splenic injury.

METHODS: This cross-sectional study was conducted on patients with traumatic splenic injuries who were hospitalized in Kashani Hospital (Isfahan, Iran) from 2017 to 2019. The studied variables were extracted from the medical records of the enrolled participants. The outcomes such as mortality complications and risk factors were compared based on treatment methods.

RESULTS: A total of 240 patients were investigated. The mean age of the patients was 29.8±12.2, with 180 (77.5%) patients being men. 154 (64.2%) patients underwent operative treatment. The mortality rate was 18.9% and 4.6% among operative and non-operative groups ( p <0.001). Complications were observed in 11.5% and 46.1% of non-operative and operative groups, respectively ( p <0.001). Operative treatment inversely correlated with mortality ( p <0.001) and complications ( p <0.05). Splenic injury severity was correlated positively with mortality ( p <0.001) and negatively with complications ( p <0.001). Unstable hemodynamic status was positively correlated with complications ( p <0.001). Age had a positive correlation with mortality ( p <0.001) and complications ( p <0.001). Male sex had a negative correlation with complications ( p <0.001). GCS score and admission were positively correlated with mortality ( p <0.001). There was no statistically significant correlation between correlated injuries and outcomes ( p ≥0.05).

CONCLUSION: Patients who received surgery had higher rates of mortality and complications. However, after controlling for confounders, operative treatment was found to be inversely correlated with mortality and complications.