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Clinical features and outcomes of blunt splenic injury in children: A retrospective study in a single institution in China.

Abstract Although the spleen is the most commonly injured intra-abdominal organ after blunt trauma, there are limited data available in China. The objectives of this study were to investigate the clinical features and determine the risk factors for operative management (OM) in children with blunt splenic injury (BSI).A review of the medical records of children diagnosed with BSI between January 2010 and September 2016 at West China Hospital of Sichuan University was performed.A total of 101 patients diagnosed with BSI were recruited, including 76 patients transferred from other hospitals. The male-to-female ratio was 2.06:1, with a mean age of 7.8 years old. The most common injury season was summer and the most common injury mechanism was road traffic accidents. Sixty-eight patients suffered multiple injuries. Thirty-four patients received blood transfusions. Two patients died from multiple organ failure or hemorrhagic shock. Significant differences were observed in the injury season, injury mechanism, injury date, and hemoglobin levels between the isolated injury group and the multiple injuries group. The overall operative rate was 29.7%. Multivariate regression analysis revealed that age, blood transfusion, and grade of injury were independent risk factors for OM.Our study provided evidence that the management of pediatric BSI was variable. The operative rate in pediatric BSI may be higher in certain patient groups. Although nonoperative management is one of the standard treatment options, our data suggest that OM is an appropriate way to treat patients who are hemodynamically unstable.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29390566
OWN - NLM
STAT- MEDLINE
DCOM- 20180212
LR  - 20180212
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 96
IP  - 51
DP  - 2017 Dec
TI  - Clinical features and outcomes of blunt splenic injury in children: A
      retrospective study in a single institution in China.
PG  - e9419
LID - 10.1097/MD.0000000000009419 [doi]
AB  - Although the spleen is the most commonly injured intra-abdominal organ after
      blunt trauma, there are limited data available in China. The objectives of this
      study were to investigate the clinical features and determine the risk factors
      for operative management (OM) in children with blunt splenic injury (BSI).A
      review of the medical records of children diagnosed with BSI between January 2010
      and September 2016 at West China Hospital of Sichuan University was performed.A
      total of 101 patients diagnosed with BSI were recruited, including 76 patients
      transferred from other hospitals. The male-to-female ratio was 2.06:1, with a
      mean age of 7.8 years old. The most common injury season was summer and the most 
      common injury mechanism was road traffic accidents. Sixty-eight patients suffered
      multiple injuries. Thirty-four patients received blood transfusions. Two patients
      died from multiple organ failure or hemorrhagic shock. Significant differences
      were observed in the injury season, injury mechanism, injury date, and hemoglobin
      levels between the isolated injury group and the multiple injuries group. The
      overall operative rate was 29.7%. Multivariate regression analysis revealed that 
      age, blood transfusion, and grade of injury were independent risk factors for
      OM.Our study provided evidence that the management of pediatric BSI was variable.
      The operative rate in pediatric BSI may be higher in certain patient groups.
      Although nonoperative management is one of the standard treatment options, our
      data suggest that OM is an appropriate way to treat patients who are
      hemodynamically unstable.
CI  - Copyright (c) 2017 The Authors. Published by Wolters Kluwer Health, Inc. All
      rights reserved.
FAU - Yang, Kaiying
AU  - Yang K
AD  - Division of Oncology, Department of Pediatric Surgery.
FAU - Li, Yanan
AU  - Li Y
AD  - Division of Oncology, Department of Pediatric Surgery.
FAU - Wang, Chuan
AU  - Wang C
AD  - Division of Oncology, Department of Pediatric Surgery.
FAU - Xiang, Bo
AU  - Xiang B
AD  - Division of Oncology, Department of Pediatric Surgery.
FAU - Chen, Siyuan
AU  - Chen S
AD  - Pediatric Intensive Care Unit, Department of Critical Care Medicine, West China
      Hospital of Sichuan University, Chengdu, China.
FAU - Ji, Yi
AU  - Ji Y
AD  - Division of Oncology, Department of Pediatric Surgery.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
SB  - AIM
SB  - IM
MH  - Adolescent
MH  - Child
MH  - Child, Preschool
MH  - China
MH  - Female
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Male
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Spleen/*injuries/pathology/surgery
MH  - Wounds, Nonpenetrating/*pathology/surgery
PMC - PMC5758268
EDAT- 2018/02/03 06:00
MHDA- 2018/02/13 06:00
CRDT- 2018/02/03 06:00
PHST- 2018/02/03 06:00 [entrez]
PHST- 2018/02/03 06:00 [pubmed]
PHST- 2018/02/13 06:00 [medline]
AID - 10.1097/MD.0000000000009419 [doi]
AID - 00005792-201712220-00153 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2017 Dec;96(51):e9419. doi: 10.1097/MD.0000000000009419.