Higher incidence of major complications after splenic embolization for blunt splenic injuries in elderly patients

Wu, Shih-Chi; Fu, Chih-Yuan; Chen, Ray-Jade; Chen, Yung-Fang; Wang, Yu-Chun; Chung, Ping-Kuei; Yu, Shu-Fen; Tung, Cheng-Cheng; Lee, Kun-Hua

doi:10.1016/j.ajem.2009.07.026

« Previous Next »American Journal of Emergency Medicine
Volume 29, Issue 2 , Pages 135-140, February 2011

Higher incidence of major complications after splenic embolization for blunt splenic injuries in elderly patients

Shih-Chi Wu, MD
- Trauma and Emergency Center, China Medical University Hospital, Taichung 404, Taiwan, R.O.C
Chih-Yuan Fu, MD
- Trauma and Emergency Center, China Medical University Hospital, Taichung 404, Taiwan, R.O.C
Ray-Jade Chen, MD
- Trauma and Emergency Center, China Medical University Hospital, Taichung 404, Taiwan, R.O.C
- Corresponding author. Tel.: +886 4 22052121x5043; fax: +886 4 22334706.
Yung-Fang Chen, MD
- Department of Radiology, China Medical University Hospital, Taichung 404, Taiwan
Yu-Chun Wang, MD
- Trauma and Emergency Center, China Medical University Hospital, Taichung 404, Taiwan, R.O.C
Ping-Kuei Chung, MD
- Trauma and Emergency Center, China Medical University Hospital, Taichung 404, Taiwan, R.O.C
Shu-Fen Yu, RN
- Division of Trauma, Changhua Christian Hospital, Changhua 500, Taiwan
Cheng-Cheng Tung, MD
- Division of Trauma, Changhua Christian Hospital, Changhua 500, Taiwan
Kun-Hua Lee, MD
- Division of Trauma, Changhua Christian Hospital, Changhua 500, Taiwan

Received 30 June 2009; received in revised form 24 July 2009; accepted 28 July 2009. published online 10 March 2010.

Abstract

Background

Nonoperative management (NOM) of blunt splenic injuries has been widely accepted, and the application of splenic artery embolization (SAE) has become an effective adjunct to NOM. However, complications do occur after SAE. In this study, we assess the factors leading to the major complications associated with SAE.

Materials and Methods

Focusing on the major complications after SAE, we retrospectively studied patients who received SAE and were admitted to 2 major referral trauma centers under the same established algorithm for management of blunt splenic injuries. The demographics, angiographic findings, and factors for major complications after SAE were examined. Major complications were considered to be direct adverse effects arising from SAE that were potentially fatal or were capable of causing disability.

Results

There were a total of 261 patients with blunt splenic injuries in this study. Of the 261 patients, 53 underwent SAE, 11 (21%) of whom were noted to have 12 major complications: 8 cases of postprocedural bleeding, 2 cases of total infarction, 1 case of splenic abscess, and 1 case of splenic atrophy. Patients older than 65 years were more susceptible to major complications after SAE.

Conclusion

Splenic artery embolization is considered an effective adjunct to NOM in patients with blunt splenic injuries. However, risks of major complications do exist, and being elderly is, in part, associated with a higher major complication incidence.