Table 3.
Demographic, clinical and outcome data of patients with and without splenic injury and splenectomy
| Variable | Category | No or late splenectomy n = 786 | Early splenectomy n = 328 | p value |
|---|---|---|---|---|
| Sex | Male | 559 (71.5%) | 221 (67.6%) | 0.20 |
| Age [years] | Mean ± SD | 40.1 ± 20.1 | 39.6 ± 19.3 | 0.82 |
| Trauma mechanism | Traffic accident | 587 (75.2%) | 242 (75.2%) | 0.39 |
| High fall | 134 (17.2%) | 65 (20.2%) | ||
| Low fall | 40 (5.1%) | 8 (2.5%) | ||
| Mechanism | Blunt | 748 (98.7%) | 309 (97.8%) | 0.28 |
| Physical status | ASA 3&4 | 64 (9.9%) | 22 (9.2%) | 0.73 |
| ISS | Median (IQR) | 34 (27–43) | 44 (41–57) | < 0.001 |
| Expected mortality (RISC-II) | Mean [%] | 20.8 | 32.7 | < 0.001 |
| AIS Head | 3 | 351 (44.7%) | 136 (41.5%) | 0.70 |
| 4 | 263 (33.5%) | 113 (34.5%) | ||
| 5/6 | 172 (21.9%) | 79 (24.1%) | ||
| Other relevant abdominal injury | AIS higher than spleen | 78 (9.9%) | 15 (4.6%) | 0.003 |
| Thorax | AIS ≥ 2 | 677 (86.1%) | 295 (89.9%) | 0.082 |
| Spine | AIS ≥ 2 | 330 (42.0%) | 146 (44.5%) | 0.44 |
| Upper extremity | AIS ≥ 2 | 395 (50.3%) | 160 (48.8%) | 0.65 |
| Lower extremity | AIS ≥ 2 | 270 (34.4%) | 124 (37.8%) | 0.27 |
| Pelvic fracture | AIS ≥ 2 | 259 (33.0%) | 136 (41.5%) | 0.007 |
| GCS | Median (IQR) | 9 (3–14) | 7 (3–13) | 0.014 |
| Unconscious | GCS ≤ 8 | 384 (49.4%) | 185 (57.3%) | 0.017 |
| Intubated on scene | Done | 536 (67.8%) | 241 (76.3%) | 0.005 |
| CPR | Done | 24 (3.0%) | 15 (4.7%) | 0.16 |
| Hypotension on scene | sysBP ≤ 90 mmHg | 152 (21.1%) | 104 (36.0%) | < 0.001 |
| sysBP on scene | mean ± SD [mmHg] | 118 ± 31 | 107 ± 34 | < 0.001 |
| Hypotension at admission | sysBP ≤ 90 mmHg | 146 (19.8%) | 117 (38.0%) | < 0.001 |
| Blood transfusion | Done | 238 (30.3%) | 200 (61.0%) | < 0.001 |
| Number of pRBC (if transfused) | Median (IQR) | 4 (2–8) | 7.5 (4–14) | < 0.001 |
| Volume (prehospital) | Median (IQR) [ml] | 1000 (500–1500) | 1275 (1000–2000) | < 0.001 |
| Volume (ER) | Median (IQR) | 1000 500–2500 | 2000 (1000–3625) | < 0.001 |
| Base excess | Mean ± SD [mmol/l] | − 3.6 ± 4.8 | − 5.2 ± 5.5 | < 0.001 |
| Hemoglobin | Mean ± SD [g/dl] | 11.8 ± 2.6 | 10.4 ± 2.9 | < 0.001 |
| Mortality | In hospital | 81 (10.3%) | 68 (20.7%) | < 0.001 |
| Outcome scale (survivor only) | 2—PVS | 50 (7.2%) | 24 (9.8%) | 0.22 |
| 3—severe | 152 (21.7%) | 62 (25.2%) | ||
| 4—moderate | 254 (36.3%) | 89 (36.2%) | ||
| 5—good | 243 (34.8%) | 71 (28.9%) | ||
| Days on ICU | Median (IQR) | 14 (6–25) | 16 (8–28) | 0.014 |
| Days in hospital | Median (IQR) | 23 (14–34) | 25 (15–39) | 0.25 |
| Duration of mechanical ventilation (days) | Median (IQR) | 7 (2–17) | 10 (4–20) | < 0.001 |
AIS Abbreviated Injury Scale, ASA American Society of Anesthesiologists Physical Status Classification, CPR cardiopulmonary resuscitation, ER emergency room, GCS Glasgow Coma Scale, ICU intensive care unit, IQR interquartile range, pRBC packed red blood cells, RISC-II Revised Injury Severity Classification, version II, sysBP systolic blood pressure, ISS Injury Severity Score, SD standard deviation, PVS persistent vegetative state