Postdischarge complications following nonoperative management of blunt splenic injury

US pediatric trauma patient unplanned 30-day readmissions

“…Readmissions are increasingly being scrutinized by public insurers, accountable care 1 organizations, and the American College of Surgeons [1][2][3][4][5][6][7]. Trauma readmissions have been promoted as a quality indicator [2,5,8], and they have been used as a metric to compare patient care approaches and hospital outcomes [9][10][11][12]. Published work has largely focused on adult trauma patient readmissions [5,8,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24].…”

“…Trauma readmissions have been promoted as a quality indicator [2,5,8], and they have been used as a metric to compare patient care approaches and hospital outcomes [9][10][11][12]. Published work has largely focused on adult trauma patient readmissions [5,8,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24]. A number of those studies are limited to single institutions that do not track readmissions at different hospitals [13,14,16,19,21].…”

Splenic hematoma may present as large bowel obstruction: A case report

“…Close follow-up is necessary for any splenic hematoma including post-SAE as bleeding may recur or abscess may develop. Freitas et al describe several complications that may occur following SNOM of blunt splenic injury, including 3–16% gastrointestinal (GI) complications (as defined by Kassin et al) [4,7]. Although a significantly higher rate of GI complications after SNOM is expected post-SAE, both patients with LBO secondary to splenic hematoma had not…”

“…Management of splenic trauma is increasingly non-operative (i.e. selective non-operative management, SNOM), and a unique array of complications may result from splenic SNOM [4]. Gastrointestinal complications occur among 3–16% of patients undergoing SNOM for splenic injury, significantly more frequently if splenic artery embolization (SAE) is employed [4].…”

Splenic artery angioembolization for high-grade splenic injury: Are we wasting money?

“…16 At the time of readmission after initial NOM, patients had a 10% ±7 probability undergoing a splenectomy. 19,20 Following splenectomy, patients were modeled to transition to either complication or success, and those with a complication were modeled to have a readmission or return to perfect state of health. The most common complications modeled following splenectomy were infectious; most frequently reported were surgical site infection (1.4e8.2%), pneumonia (1.7e25.0%), and deep space infection (3.6e6.2%).…”