title: Contribution of age and gender to outcome of blunt splenic injury in adults: multicenter study of the eastern association for the surgery of trauma.
abstract: BACKGROUND
  The purpose of this study was to examine the contribution of age and gender to outcome after treatment of blunt splenic injury in adults.
  
  
  METHODS
  Through the Multi-Institutional Trials Committee of the Eastern Association for the Surgery of Trauma (EAST), 1488 adult patients from 27 trauma centers who suffered blunt splenic injury in 1997 were examined retrospectively.
  
  
  RESULTS
  Fifteen percent of patients were 55 years of age or older. A similar proportion of patients > or = 55 went directly to the operating room compared with patients < 55 (41% vs. 38%) but the mortality for patients > or = 55 was significantly greater than patients < 55 (43% vs. 23%). Patients > or = 55 failed nonoperative management (NOM) more frequently than patients < 55 (19% vs. 10%) and had increased mortality for both successful NOM (8% vs. 4%, p < 0.05) and failed NOM (29% vs. 12%, p = 0.054). There were no differences in immediate operative treatment, successful NOM, and failed NOM between men and women. However, women > or = 55 failed NOM more frequently than women < 55 (20% vs. 7%) and this was associated with increased mortality (36% vs. 5%) (both p < 0.05).
  
  
  CONCLUSIONS
  Patients > or = 55 had a greater mortality for all forms of treatment of their blunt splenic injury and failed NOM more frequently than patients < 55. Women > or = 55 had significantly greater mortality and failure of NOM than women < 55.
authors.affiliation: University of Pittsburgh School of Medicine, Pennsylvania 15213-2582, USA. harbrechtg@msx.upmc.edu
authors.forename: B G
authors.initials: BG
authors.lastname: Harbrecht
authors.forename: A B
authors.initials: AB
authors.lastname: Peitzman
authors.forename: L
authors.initials: L
authors.lastname: Rivera
authors.forename: B
authors.initials: B
authors.lastname: Heil
authors.forename: M
authors.initials: M
authors.lastname: Croce
authors.forename: J A
authors.initials: JA
authors.lastname: Morris
authors.forename: B L
authors.initials: BL
authors.lastname: Enderson
authors.forename: S
authors.initials: S
authors.lastname: Kurek
authors.forename: M
authors.initials: M
authors.lastname: Pasquale
authors.forename: E R
authors.initials: ER
authors.lastname: Frykberg
authors.forename: J P
authors.initials: JP
authors.lastname: Minei
authors.forename: J W
authors.initials: JW
authors.lastname: Meredith
authors.forename: J
authors.initials: J
authors.lastname: Young
authors.forename: G P
authors.initials: GP
authors.lastname: Kealey
authors.forename: S
authors.initials: S
authors.lastname: Ross
authors.forename: F A
authors.initials: FA
authors.lastname: Luchette
authors.forename: M
authors.initials: M
authors.lastname: McCarthy
authors.forename: F
authors.initials: F
authors.lastname: Davis
authors.forename: D
authors.initials: D
authors.lastname: Shatz
authors.forename: G
authors.initials: G
authors.lastname: Tinkoff
authors.forename: E F
authors.initials: EF
authors.lastname: Block
authors.forename: J B
authors.initials: JB
authors.lastname: Cone
authors.forename: L M
authors.initials: LM
authors.lastname: Jones
authors.forename: T
authors.initials: T
authors.lastname: Chalifoux
authors.forename: M B
authors.initials: MB
authors.lastname: Federle
authors.forename: K D
authors.initials: KD
authors.lastname: Clancy
authors.forename: J B
authors.initials: JB
authors.lastname: Ochoa
authors.forename: S M
authors.initials: SM
authors.lastname: Fakhry
authors.forename: R
authors.initials: R
authors.lastname: Townsend
authors.forename: R M
authors.initials: RM
authors.lastname: Bell
authors.forename: L
authors.initials: L
authors.lastname: Weireter
authors.forename: M B
authors.initials: MB
authors.lastname: Shapiro
authors.forename: F
authors.initials: F
authors.lastname: Rogers
authors.forename: C M
authors.initials: CM
authors.lastname: Dunham
authors.forename: C E
authors.initials: CE
authors.lastname: McAuley
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012737:Sex Factors; D013154:Spleen / Q000293:injuries*; D016896:Treatment Outcome; D014481:United States; D014949:Wounds, Nonpenetrating / Q000401:mortality* / Q000628:therapy*