Monday, February 26, 2018

Age cutoff in splenic injury

Q; Why age more than 55 years is considered a high risk for failure of nonoperative management in splenic injury?


Answer:  The splenic capsule thins with age and above 55 years, it becomes a risk factor for failure of nonoperative management of higher-grade splenic injuries. Above age 55, a careful decision should be made on a case by case basis to choose between operative vs nonoperative care in high-grade splenic injury.


References:

1. Siriratsivawong K, Zenati M, Watson GA, Harbrecht BG. Nonoperative management of blunt splenic trauma in the elderly: does age play a role? Am Surg 2007; 73:585.


2. Godley CD, Warren RL, Sheridan RL, McCabe CJ. Nonoperative management of blunt splenic injury in adults: age over 55 years as a powerful indicator for failure. J Am Coll Surg 1996; 183:133. 


3. Krause KR, Howells GA, Bair HA, et al. Nonoperative management of blunt splenic injury in adults 55 years and older: a twenty-year experience. Am Surg 2000; 66:636. 


4. Ong AW, Eilertson KE, Reilly EF, et al. Nonoperative management of splenic injuries: significance of age. J Surg Res 2016; 201:134.

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