Delayed Complications of Nonoperative Management of Blunt Adult Splenic Trauma

OBJECTIVE To determine the incidence and type of delayed complications from nonoperative management of adult splenic injury. DESIGN Retrospective medical record review. SETTING University teaching hospital, level I trauma center. PATIENTS Two hundred eighty patients were admitted to the adult trauma service with blunt splenic injury during a 4-year period. Men constituted 66% of the population. The mean (±SEM) age was 32.2±1.0 years and the mean (±SEM) Injury Severity Score was 22.8±0.9. Fifty-nine patients (21%) died of multiple injuries within 48 hours and were eliminated from the study. One hundred thirty-four patients (48%) were treated operatively within the first 48 hours after injury and 87 patients (31%) were managed nonoperatively. MAIN OUTCOME MEASURES We reviewed the number of units of blood transfused, intensive care unit length of stay, overall length of stay, outcome, and complications occurring more than 48 hours after injury directly attributable to the splenic injury. RESULTS Patients managed nonoperatively had a significantly lower Injury Severity Score (P