PDF(Pubmed)
Abstract：
UNASSIGNED: Nonoperative management (NOM) is the standard treatment for hemodynamically stable blunt splenic injury (BSI). However, NOM failure is a significant source of morbidity and mortality. We developed a clinical risk scoring system for NOM failure in BSI.
UNASSIGNED: Data from the Japanese Trauma Data Bank from 2008 to 2018 were analyzed. Eligible patients were restricted to those who underwent NOM with high-grade BSI (Organ Injury Scale ≥3). The primary outcome was a predictive score for NOM failure based on risk estimation.
UNASSIGNED: There were 1651 patients included in this analysis, among whom 110 (6.7%) patients had NOM failure. Multivariate analysis identified seven variables associated with failed NOM: systolic blood pressure, Glasgow coma scale, Injury Severity Score, other concomitant abdominal injury, pelvic injury, high-grade BSI, and angioembolization. An eight-point predictive score was developed with a cut-off of greater than 5 points (specificity, 98.2%; sensitivity, 25.5%) with an area under the curve of 0.81.
UNASSIGNED: The clinical predictive score had good ability to predict NOM failure and may help surgeons to make better decisions for BSI.
UNASSIGNED: Data from the Japanese Trauma Data Bank from 2008 to 2018 were analyzed. Eligible patients were restricted to those who underwent NOM with high-grade BSI (Organ Injury Scale ≥3). The primary outcome was a predictive score for NOM failure based on risk estimation.
UNASSIGNED: There were 1651 patients included in this analysis, among whom 110 (6.7%) patients had NOM failure. Multivariate analysis identified seven variables associated with failed NOM: systolic blood pressure, Glasgow coma scale, Injury Severity Score, other concomitant abdominal injury, pelvic injury, high-grade BSI, and angioembolization. An eight-point predictive score was developed with a cut-off of greater than 5 points (specificity, 98.2%; sensitivity, 25.5%) with an area under the curve of 0.81.
UNASSIGNED: The clinical predictive score had good ability to predict NOM failure and may help surgeons to make better decisions for BSI.
摘要：
■非手术治疗（NOM）是血液动力学稳定的钝性脾损伤（BSI）的标准治疗方法。然而,NOM失败是发病率和死亡率的重要来源。我们开发了BSI中NOM失败的临床风险评分系统。
■分析了2008年至2018年日本创伤数据库的数据。符合条件的患者仅限于接受高级别BSI（器官损伤量表≥3）的NOM患者。主要结果是基于风险估计的NOM失败的预测评分。
■本分析包括1651例患者，其中110例(6.7%)患者出现NOM失败.多变量分析确定了与失败的NOM相关的七个变量：收缩压，格拉斯哥昏迷量表,伤害严重程度评分,其他伴随的腹部损伤，骨盆损伤,高档BSI,和血管栓塞。开发了一个8分的预测评分，其截止值大于5分(特异性，98.2%;灵敏度,25.5%),曲线下面积为0.81。
■临床预测评分具有良好的预测NOM失败的能力，可能有助于外科医生为BSI做出更好的决策。
■分析了2008年至2018年日本创伤数据库的数据。符合条件的患者仅限于接受高级别BSI（器官损伤量表≥3）的NOM患者。主要结果是基于风险估计的NOM失败的预测评分。
■本分析包括1651例患者，其中110例(6.7%)患者出现NOM失败.多变量分析确定了与失败的NOM相关的七个变量：收缩压，格拉斯哥昏迷量表,伤害严重程度评分,其他伴随的腹部损伤，骨盆损伤,高档BSI,和血管栓塞。开发了一个8分的预测评分，其截止值大于5分(特异性，98.2%;灵敏度,25.5%),曲线下面积为0.81。
■临床预测评分具有良好的预测NOM失败的能力，可能有助于外科医生为BSI做出更好的决策。
