Nonoperative Management of Adult Splenic Injuries: Success of Initial Management on the Hospital Ward

OBJECTIVE: To determine whether initial nonoperative management (NOM) of hemodynamically stable splenic injured adult patient can be safely conducted on the ward. DESIGN: Retrospective medical record and Trauma Registry review. SETTING: Level one trauma center. PATIENTS: One hundred thirty five patients, who had been admitted, over five years, and initially managed nonoperatively for splenic injury were selected for this study. Nonety-five of these patients were male and 40 female. The mean (+/- SD) age was 29 +/- 18 years and the mean (+/- SD) Injury Severity Score (ISS) was 17 +/- 10.6. There were 99 patients initially managed in teh ICU and an unexpected group of 36 patients who were managed on the ward. MEASURES: We examined ISS, AIS, length of stay (LOS), emergency department vital signs, transfusions, and outcome between the two groups. RESULTS: Patients selected for NOM on the ward had a statistically significant lower ISS scores (