@article{ref1,
title="Starting the clock: defining nonoperative management of blunt splenic injury by time",
journal="American journal of surgery",
year="2013",
author="Jeremitsky, Elan and Smith, R. Stephen and Ong, Adrian W.",
volume="205",
number="3",
pages="298-301",
abstract="BACKGROUND: There is no consensus when the designation of nonoperative management (NOM) for splenic injury (BSI) should start. We evaluated NOM success rates based on different time points after admission. <br><br>METHODS: The National Trauma Data Bank was evaluated for BSI for the year 2008. Observations were evaluated by facility, the time to splenectomy, and the volume of BSI admissions. <br><br>RESULTS: Of 15,732 BSIs identified, the overall splenectomy salvage rate was 81%. After the 5th hour, the NOM success rate was 95%. Multivariable analysis revealed that higher BSI grades, level 2 centers and community hospitals, and age ≥55 were associated with failed NOM. <br><br>CONCLUSIONS: The grade of injury is an important predictor for failure of NOM. If a 5% failure rate is to be considered a benchmark, then the 5-hour time point after admission should be used for the calculation of NOM success rates.<p /><p>Language: en</p>",
language="en",
issn="0002-9610",
doi="10.1016/j.amjsurg.2012.10.022",
url="http://dx.doi.org/10.1016/j.amjsurg.2012.10.022"
}