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Open Access

After the embo: predicting non-hemorrhagic indications for splenectomy after angioembolization in patients with blunt trauma

John F Bilello, Victoria L Sharp, Rachel C Dirks, Krista L Kaups, James W Davis
DOI: 10.1136/tsaco-2017-000159 Published 5 February 2018
John F Bilello
1Department of Surgery, Community Regional Medical Center, University of California San Francisco-Fresno, Fresno, California, USA
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Victoria L Sharp
2Department of Surgery, Beaumont Hospital, Farmington Hills, Michigan, USA
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Rachel C Dirks
1Department of Surgery, Community Regional Medical Center, University of California San Francisco-Fresno, Fresno, California, USA
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Krista L Kaups
1Department of Surgery, Community Regional Medical Center, University of California San Francisco-Fresno, Fresno, California, USA
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James W Davis
1Department of Surgery, Community Regional Medical Center, University of California San Francisco-Fresno, Fresno, California, USA
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  • Figure 1
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    Figure 1

    Comparison of white blood cell count (WBC). SAE/NOM, successful non-operative management after splenic angioembolization; SAE/SPLEN, splenectomy after splenic angioembolization.

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    Figure 2

    Comparison of PLT:WBC. SAE/NOM, successful non-operative management after splenic angioembolization; SAE/SPLEN, splenectomy after splenic angioembolization; PLT:WBC, ratio of platelet count to white blood cell count.

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    Figure 3

    Receiver operating characteristic curve of white blood cell count for outcome of splenectomy.

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    Figure 4

    Receiver operating characteristic curve of PLT:WBC ratio for outcome of splenectomy. PLT:WBC, ratio of platelet count to white blood cell count.

Tables

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  • Table 1

    Patient characteristics

    SAE/NOM
    (n=108)
    SAE/SPLEN
    (n=16)
    P value
    Age40±1946±150.16
    Male gender74 (68%)9 (56%)0.33
    ISS23±1021±140.40
    Splenic injury grade
     19 (8%)1 (6%)1.00
     214 (13%)3 (19%)0.46
     334 (32%)6 (38%)0.63
     441 (38%)4 (25%)0.31
     510 (9%)2 (12%)0.65
    Distal angioembolization87 (81%)14 (88%)0.41
    ICU admission46 (43%)11 (69%)0.05
    Hospital length of stay (days)10±1123±19<0.001
    • ICU, intensive care unit; ISS, Injury Severity Score; SAE/NOM, successful non-operative management after splenic angioembolization; SAE/SPLEN, splenectomy after splenic angioembolization.

  • Table 2

    Patient outcomes

    SAE/NOM
    (n=108)
    SAE/SPLEN
    (n=16)
    P value
    Time 1
     WBC (103/µL)17±1217±50.21
     PLT (103/µL)191±65189±640.85
     PLT:WBC14±612±60.21
    Time 2
     WBC (103/µL)12±422±6<0.001
     PLT (103/µL)244±108334±1870.096
     PLT:WBC23±1516±70.007
    • PLT, platelet count; PLT:WBC, ratio of PLT count to WBC count; SAE/NOM, successful non-operative management after splenic angioembolization; SAE/SPLEN, splenectomy after splenic angioembolization; Time 1, immediately after splenic angioembolization; Time 2, day 5 post-SAE or day of discharge for SAE/NOM, day of splenectomy for SAE/SPLEN; WBC, white blood cell count.

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After the embo: predicting non-hemorrhagic indications for splenectomy after angioembolization in patients with blunt trauma
John F Bilello, Victoria L Sharp, Rachel C Dirks, Krista L Kaups, James W Davis
Trauma Surg Acute Care Open Feb 2018, 3 (1) e000159; DOI: 10.1136/tsaco-2017-000159

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After the embo: predicting non-hemorrhagic indications for splenectomy after angioembolization in patients with blunt trauma
John F Bilello, Victoria L Sharp, Rachel C Dirks, Krista L Kaups, James W Davis
Trauma Surg Acute Care Open Feb 2018, 3 (1) e000159; DOI: 10.1136/tsaco-2017-000159
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After the embo: predicting non-hemorrhagic indications for splenectomy after angioembolization in patients with blunt trauma
John F Bilello, Victoria L Sharp, Rachel C Dirks, Krista L Kaups, James W Davis
Trauma Surgery & Acute Care Open Feb 2018, 3 (1) e000159; DOI: 10.1136/tsaco-2017-000159
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