Assessing associated factors for failure of nonoperative management in pediatric blunt liver and spleen injuries: a secondary analysis of the SHIPPs study

Nakao, Shunichiro; Katsura, Morihiro; Yagi, Masayuki; Ogura, Hiroshi; Oda, Jun

doi:https://doi.org/10.1007/s00068-024-02575-y

Assessing associated factors for failure of nonoperative management in pediatric blunt liver and spleen injuries: a secondary analysis of the SHIPPs study

Nakao, Shunichiro; Katsura, Morihiro; Yagi, Masayuki et al.

European Journal of Trauma and Emergency Surgery, 2024, 50(5), 2249-2257

Number of Access:635（2025-08-16 03:18 Counts）

Identifier to cite or link to this item: https://hdl.handle.net/11094/97606

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Title	Assessing associated factors for failure of nonoperative management in pediatric blunt liver and spleen injuries: a secondary analysis of the SHIPPs study
Creator	NRID 1000080834150 1000080834150 ORCID 0000-0001-5530-806X 0000-0001-5530-806X researchmap permalink shunichironakao shunichironakao Scopus Author ID 57216959268 57216959268 CreatorName Nakao, Shunichiro
	CreatorName Katsura, Morihiro
	CreatorName Yagi, Masayuki
	NRID 1000070301265 1000070301265 researchmap permalink read0054647 read0054647 Scopus Author ID 7202495132 7202495132 CreatorName Ogura, Hiroshi
	NRID 1000060459500 1000060459500 ORCID 0000-0002-8254-3716 0000-0002-8254-3716 researchmap permalink read0068529 read0068529 Scopus Author ID 56210537000 56210537000 CreatorName Oda, Jun
Subject	Nonoperative management
	Pediatric blunt liver injury
	Pediatric blunt spleen injury
Description	The version of record of this article, first published in European Journal of Trauma and Emergency Surgery, is available online at Publisher’s website: https://doi.org/10.1007/s00068-024-02575-y.
Abstract	Purpose: The purpose of this study was to describe the characteristics of pediatric patients who underwent nonoperative management (NOM) for blunt splenic and hepatic injuries and to explore factors associated with NOM failure. Methods: This was a secondary analysis of a multicenter cohort study of pediatric patients with blunt liver and spleen injuries in Japan. Participants included pediatric trauma patients aged 16 years or younger between 2008 and 2019 with NOM, which was defined as no surgery provided within 6 h of hospital arrival. NOM failure, defined as abdominal surgery performed after 6 h of hospital arrival, was the primary outcome. Descriptive statistics were provided and exploratory analysis to assess the associations with outcome using logistic regression. Results: During the study period, 1339 met our eligibility criteria. The median age was 9 years, with a majority being male. The median Injury Severity Score (ISS) was 10. About 14.0% required transfusion within 24 h, and 22.3% underwent interventional radiology procedures. NOM failure occurred in 1.0% of patients and the in-hospital mortality was 0.7%. Factors associated with NOM failure included age, positive focused assessment with sonography for trauma (FAST), contrast extravasation on computed tomography (CT), severe liver injury, concomitant pancreas injury, concomitant gastrointestinal injury, concomitant mesenteric injury, and ISS. Conclusions: In our study, NOM failure were rare. Older age, positive FAST, contrast extravasation on CT, severe liver injury, concomitant pancreas injury, concomitant gastrointestinal injury, concomitant mesenteric injury, and higher ISS were suggested as possible risk factors for NOM failure.
Publisher	Springer Science and Business Media Deutschland GmbH
Source Title	European Journal of Trauma and Emergency Surgery
Volume (Issue)	50(5)
Page	2249-2257
Date of Issued	2024-06-18
Language	English
Handle URL	https://hdl.handle.net/11094/97606
PISSN	18639933
eISSN	18639941
Relation.isIdenticalTo	DOI (Publisher Version) https://doi.org/10.1007/s00068-024-02575-y
Access Rights	open access
CopyRight	This article is licensed under a Creative Commons Attribution 4.0 International License.
oaire:version	Version of Record
Category	学術雑誌論文 Journal Article

Resource Type	journal article
Local Type	Journal Article
DCTERMS.bibliographicCitation	European Journal of Trauma and Emergency Surgery. 2024, 50(5), p. 2249-2257
DC.title	Assessing associated factors for failure of nonoperative management in pediatric blunt liver and spleen injuries: a secondary analysis of the SHIPPs study
DC.creator	Nakao, Shunichiro
	Katsura, Morihiro
	Yagi, Masayuki
	Ogura, Hiroshi
	Oda, Jun
DC.publisher	Springer Science and Business Media Deutschland GmbH
DC.language' scheme='DCTERMS.RFC1766	English
DCTERMS.issued' scheme='DCTERMS.W3CDTF	2024-06-18
DC.identifier	https://doi.org/10.1007/s00068-024-02575-y
DC.subject	Nonoperative management
	Pediatric blunt liver injury
	Pediatric blunt spleen injury
DC.description	The version of record of this article, first published in European Journal of Trauma and Emergency Surgery, is available online at Publisher’s website: https://doi.org/10.1007/s00068-024-02575-y.
DCTERMS.abstract	Purpose: The purpose of this study was to describe the characteristics of pediatric patients who underwent nonoperative management (NOM) for blunt splenic and hepatic injuries and to explore factors associated with NOM failure. Methods: This was a secondary analysis of a multicenter cohort study of pediatric patients with blunt liver and spleen injuries in Japan. Participants included pediatric trauma patients aged 16 years or younger between 2008 and 2019 with NOM, which was defined as no surgery provided within 6 h of hospital arrival. NOM failure, defined as abdominal surgery performed after 6 h of hospital arrival, was the primary outcome. Descriptive statistics were provided and exploratory analysis to assess the associations with outcome using logistic regression. Results: During the study period, 1339 met our eligibility criteria. The median age was 9 years, with a majority being male. The median Injury Severity Score (ISS) was 10. About 14.0% required transfusion within 24 h, and 22.3% underwent interventional radiology procedures. NOM failure occurred in 1.0% of patients and the in-hospital mortality was 0.7%. Factors associated with NOM failure included age, positive focused assessment with sonography for trauma (FAST), contrast extravasation on computed tomography (CT), severe liver injury, concomitant pancreas injury, concomitant gastrointestinal injury, concomitant mesenteric injury, and ISS. Conclusions: In our study, NOM failure were rare. Older age, positive FAST, contrast extravasation on CT, severe liver injury, concomitant pancreas injury, concomitant gastrointestinal injury, concomitant mesenteric injury, and higher ISS were suggested as possible risk factors for NOM failure.
DC.rights	This article is licensed under a Creative Commons Attribution 4.0 International License.
DC.format	97606
citation_title	Assessing associated factors for failure of nonoperative management in pediatric blunt liver and spleen injuries: a secondary analysis of the SHIPPs study
citation_author	Nakao, Shunichiro
	Katsura, Morihiro
	Yagi, Masayuki
	Ogura, Hiroshi
	Oda, Jun
citation_publisher	Springer Science and Business Media Deutschland GmbH
citation_language	English
citation_date	2024-06-18
citation_journal_title	European Journal of Trauma and Emergency Surgery
citation_volume	50
citation_issue	5
citation_firstpage	2249
citation_lastpage	2257
citation_doi	https://doi.org/10.1007/s00068-024-02575-y
citation_public_url	https://hdl.handle.net/11094/97606

Assessing associated factors for failure of nonoperative management in pediatric blunt liver and spleen injuries: a secondary analysis of the SHIPPs study

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