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Impact of the establishment of a trauma center on blunt traumatic spleen injury treatment: Comparison between pre-traumatic center and trauma center periods

BACKGROUND: The spleen is a commonly injured intra-abdominal organ from blunt trauma. In cases of traumatic blunt spleen injury, immediate treatment is often required. This study aimed to investigate the prognostic impact of the establishment of a trauma center on the treatment of patients with blun...

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Autores principales: Jang, Hyunseok, Jo, Young-Goun, Park, Yunchul, Jeong, Euisung, Lee, Naa, Kim, Jung-Chul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Kare Publishing 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10277344/
https://www.ncbi.nlm.nih.gov/pubmed/36282154
http://dx.doi.org/10.14744/tjtes.2021.03262
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author Jang, Hyunseok
Jo, Young-Goun
Park, Yunchul
Jeong, Euisung
Lee, Naa
Kim, Jung-Chul
author_facet Jang, Hyunseok
Jo, Young-Goun
Park, Yunchul
Jeong, Euisung
Lee, Naa
Kim, Jung-Chul
author_sort Jang, Hyunseok
collection PubMed
description BACKGROUND: The spleen is a commonly injured intra-abdominal organ from blunt trauma. In cases of traumatic blunt spleen injury, immediate treatment is often required. This study aimed to investigate the prognostic impact of the establishment of a trauma center on the treatment of patients with blunt trauma injury to the spleen. METHODS: We retrospectively reviewed 235 patients who visited our center from 2012 to 2019 for blunt trauma injury to the spleen. The study period was divided into two groups: January 2012 to September 2015 was the pre-center period (PCP), and September 2015 to December 2019 was the trauma center period (TCP). In each period, there were three treatment groups: Surgical group, embolization group, and conservative treatment group. The primary outcome was mortality, and the secondary outcomes were patient characteristics, such as injury severity score and abbreviated injury scale score, time from admission to intervention (both surgery and angiography embolization), and rate of spleen-preserving surgery. RESULTS: In the conservative treatment group, the Hb and hct values were relatively low in the TCP than in the PCP (p=0.007, p=0.008, respectively). The intensive care unit admission rate was relatively high in the TCP (72.9% vs. 90.6%, p=0.031). The ISS was relatively low in the TCP (18 vs. 17, p=0.001). In the surgical group, the time taken to transfer patients to the operating room after admission was greatly reduced in the TCP (151 min vs. 107 min, p=0.028). In the embolization group, the patient’s age and SBP were lower in the PCP than in the TCP (p=0.003, p=0.049, respectively); three patients had undergone embolization with CPR in the PCP, and no patient underwent CPR in the TCP. There were three deaths in PCP and none in the TCP (p=0.05). CONCLUSION: The establishment of a trauma center has led to improvements in the treatment quality and prognosis of patients with blunt trauma injury to the spleen receiving either of the three treatments.
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spelling pubmed-102773442023-06-20 Impact of the establishment of a trauma center on blunt traumatic spleen injury treatment: Comparison between pre-traumatic center and trauma center periods Jang, Hyunseok Jo, Young-Goun Park, Yunchul Jeong, Euisung Lee, Naa Kim, Jung-Chul Ulus Travma Acil Cerrahi Derg Original Article BACKGROUND: The spleen is a commonly injured intra-abdominal organ from blunt trauma. In cases of traumatic blunt spleen injury, immediate treatment is often required. This study aimed to investigate the prognostic impact of the establishment of a trauma center on the treatment of patients with blunt trauma injury to the spleen. METHODS: We retrospectively reviewed 235 patients who visited our center from 2012 to 2019 for blunt trauma injury to the spleen. The study period was divided into two groups: January 2012 to September 2015 was the pre-center period (PCP), and September 2015 to December 2019 was the trauma center period (TCP). In each period, there were three treatment groups: Surgical group, embolization group, and conservative treatment group. The primary outcome was mortality, and the secondary outcomes were patient characteristics, such as injury severity score and abbreviated injury scale score, time from admission to intervention (both surgery and angiography embolization), and rate of spleen-preserving surgery. RESULTS: In the conservative treatment group, the Hb and hct values were relatively low in the TCP than in the PCP (p=0.007, p=0.008, respectively). The intensive care unit admission rate was relatively high in the TCP (72.9% vs. 90.6%, p=0.031). The ISS was relatively low in the TCP (18 vs. 17, p=0.001). In the surgical group, the time taken to transfer patients to the operating room after admission was greatly reduced in the TCP (151 min vs. 107 min, p=0.028). In the embolization group, the patient’s age and SBP were lower in the PCP than in the TCP (p=0.003, p=0.049, respectively); three patients had undergone embolization with CPR in the PCP, and no patient underwent CPR in the TCP. There were three deaths in PCP and none in the TCP (p=0.05). CONCLUSION: The establishment of a trauma center has led to improvements in the treatment quality and prognosis of patients with blunt trauma injury to the spleen receiving either of the three treatments. Kare Publishing 2022-11-01 /pmc/articles/PMC10277344/ /pubmed/36282154 http://dx.doi.org/10.14744/tjtes.2021.03262 Text en Copyright © 2022 Turkish Journal of Trauma and Emergency Surgery https://creativecommons.org/licenses/by-nc/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
spellingShingle Original Article
Jang, Hyunseok
Jo, Young-Goun
Park, Yunchul
Jeong, Euisung
Lee, Naa
Kim, Jung-Chul
Impact of the establishment of a trauma center on blunt traumatic spleen injury treatment: Comparison between pre-traumatic center and trauma center periods
title Impact of the establishment of a trauma center on blunt traumatic spleen injury treatment: Comparison between pre-traumatic center and trauma center periods
title_full Impact of the establishment of a trauma center on blunt traumatic spleen injury treatment: Comparison between pre-traumatic center and trauma center periods
title_fullStr Impact of the establishment of a trauma center on blunt traumatic spleen injury treatment: Comparison between pre-traumatic center and trauma center periods
title_full_unstemmed Impact of the establishment of a trauma center on blunt traumatic spleen injury treatment: Comparison between pre-traumatic center and trauma center periods
title_short Impact of the establishment of a trauma center on blunt traumatic spleen injury treatment: Comparison between pre-traumatic center and trauma center periods
title_sort impact of the establishment of a trauma center on blunt traumatic spleen injury treatment: comparison between pre-traumatic center and trauma center periods
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10277344/
https://www.ncbi.nlm.nih.gov/pubmed/36282154
http://dx.doi.org/10.14744/tjtes.2021.03262
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