Angioembolization in patients with blunt splenic trauma in Germany –guidelines vs. Reality a retrospective registry-based cohort study of the TraumaRegister DGU®.
Purpose: Nonoperative management (NOM) for blunt splenic injuries (BSIs) is supported by both international and national guidelines in Germany, with high success rates even for severe organ injuries. Angioembolization (ANGIO) has been recommended for stabilizable patients with BSI requiring interven...
| Publicado en: | European Journal of Trauma & Emergency Surgery Vol. 50; no. 5; pp. 2451 - 2463 |
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| Autores principales: | , , , , , |
| Formato: | algorithm research tables/charts Journal Article |
| Publicado: |
Springer Nature
Oct2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=181133400&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 181133400 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18639933 3C05 jtl: European Journal of Trauma & Emergency Surgery issn: 18639933 maglogo: N pubinfo: dt: Oct2024 vid: 50 iid: 5 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 181133400 179661932 181133400 181133400 10.1007/s00068-024-02640-6 181133400 ppf: 2451 ppct: 12 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Angioembolization in patients with blunt splenic trauma in Germany –guidelines vs. Reality a retrospective registry-based cohort study of the TraumaRegister DGU®. aug: au: Kölbel, Benny Imach, Sebastian Engelhardt, Michael Wafaisade, Arasch Lefering, Rolf Beltzer, Christian affil: https://ror.org/00nmgny79 Department of General, Visceral and Thoracic Surgery, German Armed Forces Hospital Ulm, Oberer Eselsberg 40, 89081, Ulm, Germany sug: subj: Spleen Injuries Splenic Rupture Therapy Wounds, Nonpenetrating Therapy Embolization, Therapeutic Methods Practice Guidelines Evaluation Practice Patterns Evaluation Severity of Injury Human Germany Male Female Adult Middle Age Aged Retrospective Design Record Review Prospective Studies Descriptive Statistics Splenic Rupture Surgery Splenectomy Splenic Rupture Mortality Scales Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Purpose: Nonoperative management (NOM) for blunt splenic injuries (BSIs) is supported by both international and national guidelines in Germany, with high success rates even for severe organ injuries. Angioembolization (ANGIO) has been recommended for stabilizable patients with BSI requiring intervention since the 2016 German National Trauma Guideline. The objectives were to study treatment modalities in the adult BSI population according to different severity parameters including NOM, ANGIO and splenectomy in Germany. Methods: Between 2015 and 2020, a retrospective registry-based cohort study was performed on patients with BSIs with an Abbreviated Injury Score ≥ 2 in Germany using registry data from the TraumaRegister DGU® (TR DGU). This registry includes patients which were treated in a resuscitation room and spend more than 24-h in an intensive care unit or died in the resuscitation room. Results: A total of 2,782 patients with BSIs were included in the analysis. ANGIO was used in 28 patients (1.0%). NOM was performed in 57.5% of all patients, predominantly those with less severe organ injuries measured by the American Association for the Surgery of Trauma Organ Injury Scale (AAST) ≤ 2. The splenectomy rate for patients with an AAST ≥ 3 was 58.5%, and the overall mortality associated with BSI was 15%. Conclusions: In this cohort splenic injuries AAST ≥ 3 were predominantly managed surgically and ANGIO was rarely used to augment NOM. Therefore, clinical reality deviates from guideline recommendations regarding the use of ANGIO and NOM. Local interdisciplinary treatment protocols might close that gap in the future. pubtype: Academic Journal doctype: algorithm research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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