Contribution of age and gender to outcome of blunt splenic injury in adults: Multicenter study of the Eastern Association for the Surgery of Trauma

Background: The purpose of this study was to examine the contribution of ag e and gender to outcome after treatment of blunt splenic injury in adults. Methods: Through the Multi-Institutional Trials Committee of the Eastern As sociation for the Surgery of Trauma (EAST), 1488 adult patients from 27 tra uma centers who suffered blunt splenic injury in 1997 were examined retrosp ectively. Results: Fifteen percent of patients were 55 years of age or older. A simil ar proportion of patients greater than or equal to 55 went directly to the operating room compared with patients < 55 (41% vs. 38%) but the mortality for patients greater than or equal to 55 was significantly greater than pat ients < 55 (43% vs. 23%). Patients: greater than or equal to 55 failed nono perative management (NOM) more frequently than patients < 55 (19% vs. 10%) and had increased mortality for both successful NOM (8% vs. 4%, p < 0.05) a nd failed NOM (29% vs. 12%, p = 0.054). There were no differences in immedi ate operative treatment, successful NOM, and failed NOM between men and wom en. However, women greater than or equal to 55 failed NOM more frequently t han women < 55 (20% vs. 7%) and this was associated with increased mortalit y (36% vs. 5%) (both p < 0.05). Conclusion: Patients greater than or equal to 55 had a greater mortality fo r all forms of treatment of their blunt splenic injury and failed NOM more frequently than patients < 55. Women greater than or equal to 55 had signif icantly greater mortality and failure of NOM than women < 55.