Characteristics and outcomes by spleen grade
| Variable, n (%) | Grade 1 (n=87) | Grade 2 (n=128) | Grade 3 (n=130) | Grade 4* (n=64) | Grade 5 (n=13) | P value |
| Median age, years | 37 (27–54) | 35 (24.5–55) | 35 (25–55) | 39.5 (25–55) | 26 (22–36) | 0.25 |
| Age ≥65 years | 6 (6.9) | 15 (11.7) | 15 (11.5) | 9 (14.1) | 0 (0) | 0.42 |
| Female sex | 27 (31.0) | 43 (33.6) | 41 (31.5) | 14 (21.9) | 8 (61.5) | 0.08 |
| Cause of injury | 0.03 | |||||
| Vehicular cause | 74 (85.1) | 97 (75.8) | 89 (68.5) | 37 (57.8) | 11 (84.6) | |
| Fall cause | 9 (10.3) | 18 (14.1) | 22 (16.9) | 15 (23.4) | 1 (7.7) | |
| Other cause | 4 (4.6) | 13 (10.2) | 19 (14.6) | 12 (18.8) | 1 (7.7) | |
| ISS, median | 17 (9–27) | 17 (9–22) | 19 (11–27) | 25 (17–29) | 35 (22–38) | <0.001 |
| ED GCS score 3–8 | 12 (13.8) | 22 (17.2) | 15 (11.5) | 6 (9.4) | 0 (0) | 0.29 |
| ED RR <12 or >20 | 18 (22.8) | 35 (30.2) | 27 (21.6) | 17 (27.2) | 2 (18.2) | 0.54 |
| ED HR >120 | 11 (12.8) | 12 (9.5) | 12 (9.5) | 6 (9.4) | 4 (30.8) | 0.18 |
| ED SBP <90 | 0 (0) | 0 (0) | 0 (0) | 0 (0) | 0 (0) | NA |
| Blood type O | 36 (41.4) | 40 (31.3) | 45 (34.6) | 29 (45.3) | 5 (38.5) | 0.31 |
| First Hgb <10^ | 9 (10.3) | 18 (14.1) | 11 (8.5) | 8 (12.5) | 4 (30.8) | 0.15 |
| Outcomes | ||||||
| Mortality | 1 (1.2) | 5 (3.9) | 4 (3.1) | 2 (3.1) | 0 (0) | 0.76 |
| ICU admission | 62 (71.3) | 104 (81.3) | 115 (88.5) | 61 (95.3) | 12 (92.3) | <0.001 |
| Number of blood products, median | 8.5 (3–25) | 3.5 (2.5–6.5) | 2.0 (2–6) | 4.0 (2–6) | 2.0 (2–8) | 0.18 |
| Hospital LOS, median | 7 (2–12) | 6 (3–10.5) | 6 (4–13) | 6 (4.5–11.5) | 6 (4–10) | 0.59 |
| ICU LOS, median | 2 (1–6) | 2 (1–6) | 3 (92–6) | 3.5 (2–7) | 4 (2–5) | 0.09 |
| Failed NOM | 0 (0) | 0 (0) | 4 (3.1) | 1 (1.6) | 0 (0) | 0.15 |
*Four patients were initially grade III and one patient was initially a grade V, all were revised to grade IV.
†P values from Fishers exact test, Pearson’s χ2 test, or Wilcoxon rank-sum test for differences between grades. Bolding denotes significance <0.05.
ED, emergency department; GCS, Glasgow Coma Scale; HR, heart rate; Hgb, hemoglobin; ICU, intensive care unit; ISS, Injury Severity Score; LOS, length of stay; NA, not applicable; NOM, non-operative management; RR, respiratory rate; SBP, systolic blood pressure.