Disparities in the management of paediatric splenic injury. Issue 3 (2nd October 2018)

• Record Type: Journal Article
• Authors: Warwick, A M; Jenks, T; Fisher, R; Garrett-Cox, R; Lecky, F; Yates, D
• Is Part Of: British journal of surgery. Volume 106:Issue 3(2019)
• Page Start: 263
• Page End: 266
• Publication Date: 2018-10-02
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1002/bjs.10996
• Languages: English
• ISSNs: 0007-1323

Abstract

Abstract: Background: The non-operative management of splenic injury in children is recommended widely, and is possible in over 95 per cent of episodes. Practice appears to vary between centres. Methods: The Trauma Audit and Research Network (TARN) database was interrogated to determine the management of isolated paediatric splenic injuries in hospitals in England and Wales. Rates of non-operative management, duration of hospital stay, readmission and mortality were recorded. Management in paediatric surgical hospitals was compared with that in adult hospitals. Results: Between January 2000 and December 2015 there were 574 episodes. Children treated in a paediatric surgical hospital had a 95·7 per cent rate of non-operative management, compared with 75·5 per cent in an adult hospital ( P < 0·001). Splenectomy was done in 2·3 per cent of children in hospitals with a paediatric surgeon and in 17·2 per cent of those treated in an adult hospital ( P < 0·001). There was a significant difference in the rate of non-operative management in children of all ages. There was some improvement in non-operative management in adult hospitals in the later part of the study, but significant ongoing differences remained. Conclusion: The management of children with isolated splenic injury is different depending on where they are treated. The rate of non-operative management is lower in hospitals without a paediatric surgeon present. Abstract : Better in hospitals with a paediatric surgeon