title: Comparing Readmissions and Infectious Complications of Blunt Splenic Injuries Using a Statewide Database.
abstract: BACKGROUND
  Although non-operative management of blunt splenic injury (BSI) is increasingly common, the long-term infectious complications after adjunct splenic artery embolization (SAE) are not well described.
  
  
  METHODS
  Patients aged 18-64 y with BSI were identified in the California State Inpatient Database (2007-2011) and categorized as receiving either non-operative management (NOM) without SAE, NOM with SAE, or operative management (OM). The cumulative incidence of infections (surgical site infections [SSI], pneumonia, urinary tract infections, and sepsis) requiring readmission at different times up to one y after injury were calculated. Patient and treatment factors associated with infectious readmissions were determined using multivariable logistic regression models.
  
  
  RESULTS
  Of the 4,360 patients with BSI, 61.6% had NOM without SAE, 5.8% had NOM with SAE, and 32.6% had OM. The cumulative incidences of infectious complications after each of the management modes were 1.27%, 1.59%, and 1.76%, respectively, during admission (p = 0.446); 2.16%, 5.18%, and 4.85%, respectively, at 30 d after injury (p < 0.001); and 4.69%, 9.16%, and 8.85%, respectively, at one y after injury (p < 0.001). Risk factors for infection-associated readmissions within one y after injury were Charlson score ≥2 (adjusted odds ratio [AOR] 3.9; 95% confidence interval [CI] 2.61-6.02), length of stay >seven d (AOR 2.47; 95% CI 1.58-3.85), NOM with SAE (AOR 2.00; 95% CI 1.19-3.34), and OM (AOR 1.47; 95% CI 1.05-2.07).
  
  
  CONCLUSIONS
  The long-term risk of infectious complications in patients with BSI who have NOM with SAE is similar to that in patients who are treated with OM, indicating the need for pro-active strategies to reduce long-term infectious complications after SAE.
authors: 1 Division of Trauma, Burn, and Surgical Critical Care, Department of Surgery, Brigham and Women's Hospital , Boston, Massachusetts.|2 Center for Surgery and Public Health, Brigham and Women's Hospital , Harvard Medical School, and Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
authors: Olubode A
authors: OA
authors: Olufajo
authors: 2 Center for Surgery and Public Health, Brigham and Women's Hospital , Harvard Medical School, and Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
authors: Arturo
authors: A
authors: Rios-Diaz
authors: 1 Division of Trauma, Burn, and Surgical Critical Care, Department of Surgery, Brigham and Women's Hospital , Boston, Massachusetts.
authors: Allan B
authors: AB
authors: Peetz
authors: 1 Division of Trauma, Burn, and Surgical Critical Care, Department of Surgery, Brigham and Women's Hospital , Boston, Massachusetts.|2 Center for Surgery and Public Health, Brigham and Women's Hospital , Harvard Medical School, and Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
authors: Katherine J
authors: KJ
authors: Williams
authors: 1 Division of Trauma, Burn, and Surgical Critical Care, Department of Surgery, Brigham and Women's Hospital , Boston, Massachusetts.|2 Center for Surgery and Public Health, Brigham and Women's Hospital , Harvard Medical School, and Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
authors: Joaquim M
authors: JM
authors: Havens
authors: 1 Division of Trauma, Burn, and Surgical Critical Care, Department of Surgery, Brigham and Women's Hospital , Boston, Massachusetts.|2 Center for Surgery and Public Health, Brigham and Women's Hospital , Harvard Medical School, and Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
authors: Zara R
authors: ZR
authors: Cooper
authors: 1 Division of Trauma, Burn, and Surgical Critical Care, Department of Surgery, Brigham and Women's Hospital , Boston, Massachusetts.
authors: Jonathan D
authors: JD
authors: Gates
authors: 1 Division of Trauma, Burn, and Surgical Critical Care, Department of Surgery, Brigham and Women's Hospital , Boston, Massachusetts.|2 Center for Surgery and Public Health, Brigham and Women's Hospital , Harvard Medical School, and Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
authors: Adil H
authors: AH
authors: Haider
authors: 1 Division of Trauma, Burn, and Surgical Critical Care, Department of Surgery, Brigham and Women's Hospital , Boston, Massachusetts.|2 Center for Surgery and Public Health, Brigham and Women's Hospital , Harvard Medical School, and Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
authors: Ali
authors: A
authors: Salim
authors: 1 Division of Trauma, Burn, and Surgical Critical Care, Department of Surgery, Brigham and Women's Hospital , Boston, Massachusetts.|2 Center for Surgery and Public Health, Brigham and Women's Hospital , Harvard Medical School, and Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
authors: Reza
authors: R
authors: Askari
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections / Q000453:epidemiology*; D002140:California / Q000453:epidemiology; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission; D013154:Spleen / Q000293:injuries*; D014947:Wounds and Injuries / Q000150:complications* / Q000628:therapy*; D055815:Young Adult