Contribution of age and gender to outcome of blunt splenic injury in adults: Multicenter study of the Eastern Association for the Surgery of Trauma

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 greater than or equal to 55 went directly to the operating room compared with patients < 55 (41% vs. 38%) but the mortality for patients greater than or equal to 55 was significantly greater than patients < 55 (43% vs. 23%). Patients: greater than or equal to 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 greater than or equal to 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). Conclusion: Patients greater than or equal to 55 had a greater mortality for all forms of treatment of their blunt splenic injury and failed NOM more frequently than patients < 55. Women greater than or equal to 55 had significantly greater mortality and failure of NOM than women < 55.