Physiology after pediatric splenic injury.
BACKGROUND
The splenic injury computed tomographic (CT) grade is used to guide nonoperative management. A study was conducted to determine whether this grade correlates with patient physiology.


METHODS
Records of consecutive children with isolated spleen injuries were reviewed. Vital signs, fluids administered, urine output, and hematocrit values from the scene through 120 hours after admission were retrieved. A blinded radiologist reviewed CT scans. Statistical analyses were conducted to test for a linear relationship between injury grade and physiologic parameters.


RESULTS
Eighty-two patients with isolated splenic injuries and available CT scans were located. CT injury grade correlated directly with pulse, systolic blood pressure, and diastolic blood pressure and inversely with hematocrit. No correlation was found with pulse pressure, urine output, or maximum temperature.


CONCLUSIONS
The CT grade of splenic injury correlates directly with pulse, systolic blood pressure, and diastolic blood pressure and inversely with hematocrit. CT injury grade correlates with physiologic impact and may guide management decisions.
Mooney
David P
DP
Department of Surgery, Children's Hospital Boston and Harvard Medical School, Boston, Massachusetts 02115, USA. david.mooney@tch.harvard.edu
Downard
Cynthia
C
Johnson
Sidney
S
Atkinson
Carole C
CC
Forbes
Peter W
PW
Taylor
George T
GT
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D008297:Male; D008991:Monitoring, Physiologic; D012189:Retrospective Studies; D013154:Spleen / Q000000981:diagnostic imaging* / Q000293:injuries*; D014057:Tomography, X-Ray Computed