Higher incidence of major complications after splenic embolization for blunt splenic injuries in elderly patients.
BACKGROUND
Nonoperative management (NOM) of blunt splenic injuries has been widely accepted, and the application of splenic artery embolization (SAE) has become an effective adjunct to NOM. However, complications do occur after SAE. In this study, we assess the factors leading to the major complications associated with SAE.


METHODS
Focusing on the major complications after SAE, we retrospectively studied patients who received SAE and were admitted to 2 major referral trauma centers under the same established algorithm for management of blunt splenic injuries. The demographics, angiographic findings, and factors for major complications after SAE were examined. Major complications were considered to be direct adverse effects arising from SAE that were potentially fatal or were capable of causing disability.


RESULTS
There were a total of 261 patients with blunt splenic injuries in this study. Of the 261 patients, 53 underwent SAE, 11 (21%) of whom were noted to have 12 major complications: 8 cases of postprocedural bleeding, 2 cases of total infarction, 1 case of splenic abscess, and 1 case of splenic atrophy. Patients older than 65 years were more susceptible to major complications after SAE.


CONCLUSIONS
Splenic artery embolization is considered an effective adjunct to NOM in patients with blunt splenic injuries. However, risks of major complications do exist, and being elderly is, in part, associated with a higher major complication incidence.
Wu
Shih-Chi
SC
Trauma and Emergency Center, China Medical University Hospital, Taiwan, Republic of China. rw114@mail.cmuh.org.tw
Fu
Chih-Yuan
CY
Chen
Ray-Jade
RJ
Chen
Yung-Fang
YF
Wang
Yu-Chun
YC
Chung
Ping-Kuei
PK
Yu
Shu-Fen
SF
Tung
Cheng-Cheng
CC
Lee
Kun-Hua
KH
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D012307:Risk Factors; D013154:Spleen / Q000098:blood supply / Q000293:injuries*; D013157:Splenic Artery; D015599:Trauma Severity Indices; D014949:Wounds, Nonpenetrating / Q000628:therapy*; D055815:Young Adult