The incidence of delayed splenic bleeding in pediatric blunt trauma

David M. Notrica, Lois W. Sayrs, Amina Bhatia, Robert W. Letton, Adam Alder, Shawn St. Peter, Todd A. Ponsky, James W. Eubanks, Karla A. Lawson, Daniel J. Ostlie, David W. Tuggle, Nilda M. Garcia, R. Todd Maxson, Charles Leys, Cynthia Greenwell

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: One of the concerns associated with nonoperative management of splenic injury in children has been delayed splenic bleed (DSB) after a period of hemostasis. This study evaluates the incidence of DSB from a multicenter 3-year prospective study of blunt splenic injuries (BSI). Methods: A 3-year prospective study was done to evaluate nonoperative management of pediatric (≤. 18. years) BSI presenting to one of 10 pediatric trauma centers. Patients were tracked at 14 and 60. days. Descriptive statistics were used to summarize patient and injury characteristics. Results: During the study period, 508 children presented with BSI. Median age was 11.6 [IQR: 7.0, 14.8]; median splenic injury grade was 3 [IQR: 2, 4]. Nonoperative management was successful in 466 (92%) with 18 (3.5%) patients undergoing splenectomy at the index admission, all within 3. h of injury. No patient developed a delayed splenic bleed. At least one follow-up visit was available for 372 (73%) patients. Conclusion: A prior single institution study suggested that the incidence of DSB was 0.33%. Based on our results, we believe that the rate may be less than 0.2%. Level of evidence: Level II, Prognosis.

Original languageEnglish (US)
JournalJournal of Pediatric Surgery
DOIs
StateAccepted/In press - 2017

Fingerprint

Nonpenetrating Wounds
Pediatrics
Hemorrhage
Incidence
Wounds and Injuries
Cohort Studies
Prospective Studies
Trauma Centers
Splenectomy
Hemostasis

Keywords

  • Abdominal trauma
  • Blunt trauma
  • Delayed bleed
  • Injury
  • Pediatric
  • Splenic injury

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

Notrica, D. M., Sayrs, L. W., Bhatia, A., Letton, R. W., Alder, A., St. Peter, S., ... Greenwell, C. (Accepted/In press). The incidence of delayed splenic bleeding in pediatric blunt trauma. Journal of Pediatric Surgery. https://doi.org/10.1016/j.jpedsurg.2017.10.005

The incidence of delayed splenic bleeding in pediatric blunt trauma. / Notrica, David M.; Sayrs, Lois W.; Bhatia, Amina; Letton, Robert W.; Alder, Adam; St. Peter, Shawn; Ponsky, Todd A.; Eubanks, James W.; Lawson, Karla A.; Ostlie, Daniel J.; Tuggle, David W.; Garcia, Nilda M.; Maxson, R. Todd; Leys, Charles; Greenwell, Cynthia.

In: Journal of Pediatric Surgery, 2017.

Research output: Contribution to journalArticle

Notrica, DM, Sayrs, LW, Bhatia, A, Letton, RW, Alder, A, St. Peter, S, Ponsky, TA, Eubanks, JW, Lawson, KA, Ostlie, DJ, Tuggle, DW, Garcia, NM, Maxson, RT, Leys, C & Greenwell, C 2017, 'The incidence of delayed splenic bleeding in pediatric blunt trauma', Journal of Pediatric Surgery. https://doi.org/10.1016/j.jpedsurg.2017.10.005
Notrica, David M. ; Sayrs, Lois W. ; Bhatia, Amina ; Letton, Robert W. ; Alder, Adam ; St. Peter, Shawn ; Ponsky, Todd A. ; Eubanks, James W. ; Lawson, Karla A. ; Ostlie, Daniel J. ; Tuggle, David W. ; Garcia, Nilda M. ; Maxson, R. Todd ; Leys, Charles ; Greenwell, Cynthia. / The incidence of delayed splenic bleeding in pediatric blunt trauma. In: Journal of Pediatric Surgery. 2017.
@article{cd23cc0a30e2492c98993ce97e1e4590,
title = "The incidence of delayed splenic bleeding in pediatric blunt trauma",
abstract = "Background: One of the concerns associated with nonoperative management of splenic injury in children has been delayed splenic bleed (DSB) after a period of hemostasis. This study evaluates the incidence of DSB from a multicenter 3-year prospective study of blunt splenic injuries (BSI). Methods: A 3-year prospective study was done to evaluate nonoperative management of pediatric (≤. 18. years) BSI presenting to one of 10 pediatric trauma centers. Patients were tracked at 14 and 60. days. Descriptive statistics were used to summarize patient and injury characteristics. Results: During the study period, 508 children presented with BSI. Median age was 11.6 [IQR: 7.0, 14.8]; median splenic injury grade was 3 [IQR: 2, 4]. Nonoperative management was successful in 466 (92{\%}) with 18 (3.5{\%}) patients undergoing splenectomy at the index admission, all within 3. h of injury. No patient developed a delayed splenic bleed. At least one follow-up visit was available for 372 (73{\%}) patients. Conclusion: A prior single institution study suggested that the incidence of DSB was 0.33{\%}. Based on our results, we believe that the rate may be less than 0.2{\%}. Level of evidence: Level II, Prognosis.",
keywords = "Abdominal trauma, Blunt trauma, Delayed bleed, Injury, Pediatric, Splenic injury",
author = "Notrica, {David M.} and Sayrs, {Lois W.} and Amina Bhatia and Letton, {Robert W.} and Adam Alder and {St. Peter}, Shawn and Ponsky, {Todd A.} and Eubanks, {James W.} and Lawson, {Karla A.} and Ostlie, {Daniel J.} and Tuggle, {David W.} and Garcia, {Nilda M.} and Maxson, {R. Todd} and Charles Leys and Cynthia Greenwell",
year = "2017",
doi = "10.1016/j.jpedsurg.2017.10.005",
language = "English (US)",
journal = "Journal of Pediatric Surgery",
issn = "0022-3468",
publisher = "W.B. Saunders Ltd",

}

TY - JOUR

T1 - The incidence of delayed splenic bleeding in pediatric blunt trauma

AU - Notrica, David M.

AU - Sayrs, Lois W.

AU - Bhatia, Amina

AU - Letton, Robert W.

AU - Alder, Adam

AU - St. Peter, Shawn

AU - Ponsky, Todd A.

AU - Eubanks, James W.

AU - Lawson, Karla A.

AU - Ostlie, Daniel J.

AU - Tuggle, David W.

AU - Garcia, Nilda M.

AU - Maxson, R. Todd

AU - Leys, Charles

AU - Greenwell, Cynthia

PY - 2017

Y1 - 2017

N2 - Background: One of the concerns associated with nonoperative management of splenic injury in children has been delayed splenic bleed (DSB) after a period of hemostasis. This study evaluates the incidence of DSB from a multicenter 3-year prospective study of blunt splenic injuries (BSI). Methods: A 3-year prospective study was done to evaluate nonoperative management of pediatric (≤. 18. years) BSI presenting to one of 10 pediatric trauma centers. Patients were tracked at 14 and 60. days. Descriptive statistics were used to summarize patient and injury characteristics. Results: During the study period, 508 children presented with BSI. Median age was 11.6 [IQR: 7.0, 14.8]; median splenic injury grade was 3 [IQR: 2, 4]. Nonoperative management was successful in 466 (92%) with 18 (3.5%) patients undergoing splenectomy at the index admission, all within 3. h of injury. No patient developed a delayed splenic bleed. At least one follow-up visit was available for 372 (73%) patients. Conclusion: A prior single institution study suggested that the incidence of DSB was 0.33%. Based on our results, we believe that the rate may be less than 0.2%. Level of evidence: Level II, Prognosis.

AB - Background: One of the concerns associated with nonoperative management of splenic injury in children has been delayed splenic bleed (DSB) after a period of hemostasis. This study evaluates the incidence of DSB from a multicenter 3-year prospective study of blunt splenic injuries (BSI). Methods: A 3-year prospective study was done to evaluate nonoperative management of pediatric (≤. 18. years) BSI presenting to one of 10 pediatric trauma centers. Patients were tracked at 14 and 60. days. Descriptive statistics were used to summarize patient and injury characteristics. Results: During the study period, 508 children presented with BSI. Median age was 11.6 [IQR: 7.0, 14.8]; median splenic injury grade was 3 [IQR: 2, 4]. Nonoperative management was successful in 466 (92%) with 18 (3.5%) patients undergoing splenectomy at the index admission, all within 3. h of injury. No patient developed a delayed splenic bleed. At least one follow-up visit was available for 372 (73%) patients. Conclusion: A prior single institution study suggested that the incidence of DSB was 0.33%. Based on our results, we believe that the rate may be less than 0.2%. Level of evidence: Level II, Prognosis.

KW - Abdominal trauma

KW - Blunt trauma

KW - Delayed bleed

KW - Injury

KW - Pediatric

KW - Splenic injury

UR - http://www.scopus.com/inward/record.url?scp=85032180765&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85032180765&partnerID=8YFLogxK

U2 - 10.1016/j.jpedsurg.2017.10.005

DO - 10.1016/j.jpedsurg.2017.10.005

M3 - Article

C2 - 29079311

AN - SCOPUS:85032180765

JO - Journal of Pediatric Surgery

JF - Journal of Pediatric Surgery

SN - 0022-3468

ER -