کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
6253308 | 1288387 | 2016 | 7 صفحه PDF | دانلود رایگان |
BackgroundIn the nonoperative management (NOM) of blunt splenic injuries (BSI), the clinical relevance of age as a risk factor has not been well studied.MethodsUsing the 2011 National Trauma Data Bank data set, age was analyzed both as a continuous variable and a categorical variable (group 1 [13-54 y], group 2 [55-74 y], and group 3 [â¥75 y]). BSI severity was stratified by abbreviated injury scale (AIS): group 1 (AIS â¤2), group 2 (AIS 3), and group 3 (AIS â¥4). A semiparametric proportional odds model was used to model NOM outcomes and effects due to age and BSI severity.ResultsOf 15,113 subjects, 15.3% failed NOM. The odds of failure increased by a factor of 1.014 for each year of age, or factor of 1.5 for groups 2 and 3 each. BSI severity groups 2 and 3 had increases in the odds of failure by factors of 3.9 and 13, respectively, compared with those of group 1. Most failures occurred by 48 h irrespective of age. The effect of age was most pronounced in age groups 2 and 3 with the most severe BSI, where a NOM failure rate of >50% was seen. Both age and failure of NOM were independent predictors of mortality.ConclusionsAge is associated with failure of NOM but its effect seems more clinically relevant only in high-grade BSI. Factors that could influence NOM success in elderly patients with high-grade injuries deserve further study.
Journal: Journal of Surgical Research - Volume 201, Issue 1, March 2016, Pages 134-140