Oklahoma Children's Hospital at OU Health, Department of Pediatric Surgery, 1200 Children's Ave, Oklahoma City, OK, 73104, USA.
The University of Oklahoma Health Sciences Center, Department of Surgery, 800 Stanton L. Blvd, Oklahoma City, OK, 73190, USA.
Am J Surg. 2022 Jul;224(1 Pt A):185-189. doi: 10.1016/j.amjsurg.2021.12.010. Epub 2021 Dec 15.
Management guidelines for pediatric blunt spleen injuries (BSI) include adolescent patients but few studies have compared current management of adolescents with respect to other age groups by center type.
A retrospective review of 2017-2018 National Trauma Quality Improvement (TQIP) data of children (6-12), adolescents (13-17) and young adults (18-24) with BSI presenting to an adult, pediatric only, or adult/pediatric trauma center, comparing the rate of splenic intervention for adolescents by trauma center was performed.
Children had lower odds of spleen intervention than adolescents at both adult (OR 0.61 95%CI 0.39, 0.95) and adult/pediatric (OR 0.55 95%CI 0.35, 0.87) centers but did not differ at pediatric centers (OR 0.94 95%CI 0.39, 2.2) (n = 10,494). Adolescents adjusted odds of intervention was equal to adults at adult trauma centers (OR 1.2 95%CI 0.95, 1.4).
Adolescents are more likely to undergo interventions for BSI as compared to children at both adult and adult/pediatric trauma centers.
儿科钝性脾损伤 (BSI) 的管理指南包括青少年患者，但很少有研究根据中心类型比较青少年与其他年龄组的当前管理方法。
回顾性分析了 2017-2018 年国家创伤质量改进 (TQIP) 数据中 6-12 岁儿童、13-17 岁青少年和 18-24 岁青年 BSI 患者的数据，比较了成人、儿科或成人/儿科创伤中心中青少年脾干预的发生率。
与儿科中心相比，在成人 (OR 0.61, 95%CI 0.39, 0.95) 和成人/儿科 (OR 0.55, 95%CI 0.35, 0.87) 中心，儿童脾干预的可能性低于青少年，但在儿科中心无差异 (OR 0.94, 95%CI 0.39, 2.2) (n=10494)。在成人创伤中心，青少年干预的调整比值比与成年人相等 (OR 1.2, 95%CI 0.95, 1.4)。
与儿童相比，青少年在成人和成人/儿科创伤中心更有可能接受 BSI 干预。
