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• W3007909684 abstract "Although the safety and efficacy of splenic artery embolization (SAE) in adults with splenic injury (SI) is well described, research is sparse in the pediatric population. We aimed to characterize current national utilization and comparative outcomes of SAE in pediatric patients with SI. All patients under 18 years of age with SI in the National Trauma Data Bank between 2007 and 2015 were identified. To avoid outcome confounders, those with any grade aortic injury, grade III or higher traumatic brain or spinal injury, and grade IV or V injuries in other organs were excluded. Focusing on surgery, SAE, and non-operative management (NOM) in patients with SI, the utilization rate of each treatment modality for each American Association for Surgery of Trauma (AAST) Injury Scoring Scale grade of splenic injury was performed. Tukey’s tests were used for pairwise comparisons of treatment modalities for the outcomes length of stay [LOS], intensive care unit [ICU] days, and ventilation days. Overall, 24,128 pediatric SI trauma patients met inclusion criteria. Of these, 21,789 (90%) patients received NOM, and 1,361 (5.6%) were treated with splenectomy and 386 (1.6%) with SAE. Between 2007 and 2015, the proportion of patients undergoing SAE increased from 0.5% to 2.3%, the rate of NOM increased negligibly from 90% to 91%, and the rate of splenectomy decreased from 6.9% to 4.4%. Combining injury grades, NOM was associated with the shortest LOS (3.7 days), ICU stays (1.9 days), and ventilator days (0.6 days). When compared with splenectomy, patients with SAE had shorter LOS (6.4 vs. 8.8 days, P <0.001), shorter ICU stays (3.6 vs. 4.4 days, P <0.001), and fewer ventilator days (1.3 vs. 2.1 days, P <0.001). SAE failure was observed in only 9 of 386 patients (2.3%). Across all injury levels, splenectomy had the highest rate of mortality (10%) compared to SAE (0.8%) and NOM (1.2%; P <0.001). There was no difference in survival between SAE and NOM groups (P = 1.0). Most pediatric patients with SI receive NOM, and this is overwhelmingly effective. In patients requiring interventions, SAE is a safe and effective alternative to splenectomy, and its utilization is increasing nationwide.Tabled 1Type of Procedure in Pediatric Splenic Injury by Injury Grade and YearSAENOMSplenectomyTotal PatientsGrade2170 (1.6%)10,290 (94.1%)195 (1.8%)10,930393 (1.3%)6572 (93.1%)257 (3.6%)7060498 (2.0%)4066 (85.2%)470 (9.9%)4769525 (1.8%)861 (62.9%)439 (32.1%)1369Year200711 (0.5%)1965 (90%)150 (6.9%)2814200821 (1.1%)1807 (90%)119 (6.0%)2000200928 (0.8%)2960 (90%)226 (6.9%)3296201050 (1.7%)2672 (90%)161 (5.5%)2953201148 (1.6%)2745 (91%)163 (5.4%)3021201251 (1.8%)2615 (91%)152 (5.3%)2881201344 (1.7%)2370 (91%)143 (5.5%)2613201471 (2.9%)2192 (90%)129 (5.2%)2469201562 (2.3%)2463 (91%)118 (4.4%)2711 Open table in a new tab" @default.
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• W3007909684 date "2020-03-01" @default.
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• W3007909684 title "4:12 PM Abstract No. 164 The role of interventional radiology in the contemporary management of pediatric blunt splenic trauma: a National Trauma Data Bank analysis" @default.
• W3007909684 doi "https://doi.org/10.1016/j.jvir.2019.12.199" @default.
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