@article{ref1,
title="Age is a predictor for mortality after blunt splenic injury",
journal="American journal of surgery",
year="2020",
author="Warnack, Elizabeth and Bukur, Marko and Frangos, Spiros and DiMaggio, Charles and Kozar, Rosemary A. and Klein, Michael and Berry, Cherisse",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: While the incidence of geriatric trauma continues to increase, the management of high-grade blunt splenic injury (BSI) in the elderly remains controversial. Among this population, data evaluating survival rates following non-operative and operative management are inconsistent. We analyzed mortality risk in geriatric patients with high-grade BSI based on operative vs. non-operative management. <br><br>METHODS: A retrospective analysis of the National Trauma Database identified patients with isolated, high-grade (AIS ≥ 3) BSI from 2014 to 2015. Patients were stratified into three groups: non-elderly (<65 years), elderly (65-79 years), and advanced age (80 years and older). Each age group was stratified into three management groups: non-operative (including embolization), initial operative management (OR within 24 h), and failed non-operative management. Patient characteristics and outcomes were compared. Multivariable logistic regression estimated association with mortality. <br><br>RESULTS: 5560 patients with isolated, high-grade BSI were identified. In the group that failed NOM, mortality was 2% in non-elderly patients, versus 22.2% in elderly patients and 50% in patients of advanced age (p < .01). In this group, patients over 80 years old spent an average of 6.5 days longer in the ICU vs. non-elderly patients (median 10.5 days, IQR [6.75, 19.5] vs. 4 days, IQR [3,6], p = 0.02). In patients with isolated, high grade BSI, age was independently associated with mortality (AOR 1.02; p < 0.01). Elderly patients who required surgery were over three times more likely to die (AOR 3.39; p < 0.01). Advanced age patients who required surgery were over eight times more likely to die (AOR 8.1; p < 0.01). <br><br>CONCLUSIONS: For patients with BSI, age is independently associated with death in both operative and non-operative cases.<br><br>Copyright © 2020 Elsevier Inc. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0002-9610",
doi="10.1016/j.amjsurg.2020.01.053",
url="http://dx.doi.org/10.1016/j.amjsurg.2020.01.053"
}