Retrospective Observational Study of the Management of Blunt Traumatic Splenic Injury 2017-2022 at Major Trauma Centres in England. What is the Current Role of Splenic Artery Embolisation?.

Jenkins, P.; Sorrell, L.; Zhong, J.; Harding, J.; Modi, S.; Smith, JE.; Allgar, V.; Roobottom, C.

Retrospective Observational Study of the Management of Blunt Traumatic Splenic Injury 2017-2022 at Major Trauma Centres in England. What is the Current Role of Splenic Artery Embolisation?.

All Authors

Jenkins, P.

Sorrell, L.

Zhong, J.

Harding, J.

Modi, S.

Smith, JE.

Allgar, V.

Roobottom, C.

LTHT Author

Zhong, Jim

LTHT Department

Hepatobiliary Surgery
Liver Unit

Publication Date

2025

Item Type

Journal Article
Observational Study
Multicenter Study

Abstract

BACKGROUND: PURPOSE : To compare the treatment and outcomes of blunt splenic injury (BSI) management strategy within Major Trauma centres in England between 2017 and 2022. METHODS: Data was extracted from UK TARN (Trauma Audit Research Network) identifying all splenic injuries admitted to English Major Trauma Centres (MTCs) between 01/01/17 and 31/12/21. Mechanism, injuries, treatment and outcomes were compared between management strategies according to American Association of Surgery in Trauma (AAST) grade over the period. The main endpoints of splenic salvage rate, along with mortality and length of stay were compared between the treatment options. RESULTS: 3,723 patients sustained BSI; 2,906 (78.1%) were managed conservatively, 491 (13.2%) underwent embolisation while 326 (8.8%) underwent splenectomy. There were 1895 (50.9%) AAST grade 2 injuries, 1019 (27.4%) grade 3, 592 (15.9%) grade 4 and 247 (6.6%) grade 5. Embolisation was successful (i.e. no subsequent splenectomy) for 465/491 (94.7%). The length of stay of discharged patients in the splenectomy group was longer than in those receiving embolisation (p = 0.001) or conservative management (p < 0.001) (median (IQR) of 12 (7, 27), 10 (6, 19), 10 (6, 20) days, respectively). Mortality at 30 days was not significantly different in those who underwent splenectomy (12.3%) compared to embolisation (8.6%) and conservative management (11.5%) (p = 0.129). CONCLUSION: Splenic embolisation results in a high rate of splenic salvage.