METHODS: Patients with a blunt splenic injury admitted to a Level I trauma center were reviewed from 2016 to 2021. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for splenectomy were calculated for high-grade injuries (AAST-OIS grades IV-V) using both schemas.
RESULTS: Of the 852 patients analyzed, 48.5% were observed, 24.6% were embolized, and the remaining underwent operative intervention. The median AAST-OIS increased from II to III (p < 0.01). Sensitivity (38.0% vs. 73.7%) and NPV (80.9% vs. 88.2%) for splenectomy increased for high-grade injuries but specificity (93.5% vs 70.1%) and PPV (67.5% vs 46.7%) decreased.
CONCLUSIONS: The revised AAST-OIS better predicted splenic salvage but is less accurate at predicting need for splenectomy.
方法:回顾了2016年至2021年I级创伤中心收治的钝性脾损伤患者。灵敏度,特异性,使用两种模式计算高级别损伤(AAST-OISIV-V级)的脾切除术的阳性预测值(PPV)和阴性预测值(NPV).
结果:在分析的852例患者中,观察到48.5%,24.6%被栓塞,其余患者接受手术干预。AAST-OIS中位数从II增加到III(p<0.01)。敏感度(38.0%vs.73.7%)和净现值(80.9%与对于严重损伤,脾切除术的88.2%)增加,但特异性(93.5%vs70.1%)和PPV(67.5%vs46.7%)降低。
结论:修正后的AAST-OIS能更好地预测脾挽救,但在预测脾切除需要时准确性较差。