{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T09:12:18Z","timestamp":1790154738035,"version":"4.0.1"},"reference-count":16,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T00:00:00Z","timestamp":1758240000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,9,19]],"date-time":"2025-09-19T00:00:00Z","timestamp":1758240000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2025,11]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Non\u2010operative management (NOM) is often successful with an adjunctive use of splenic angioembolization (SAE) in patients with high\u2010grade blunt splenic injuries (BSI). This study aimed to evaluate the variation between US trauma centers in the use of SAE for high\u2010grade BSI undergoing NOM.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This retrospective cohort study utilized the American College of Surgeons Trauma Quality Improvement Program database. We included adult patients (age \u2265 16\u00a0years) with isolated high\u2010grade BSI (Abbreviated Injury Scale 3\u20135) from 2013 to 2021. A logistic regression model was developed to estimate the use of SAE, and trauma centers were stratified by the observed to estimated SAE ratio using tertile ranges: low, medium, and high tendencies for the use of SAE. Hierarchical logistic regression accounted for clustering at the institution level and identified factors associated with overall splenectomy.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 8729 patients were included. After adjusting for trauma center case mix, the use of SAE was associated with a low likelihood of overall splenectomy (odds ratio [OR]: 0.12, 95% confidence interval [CI]: 0.09\u20130.14,\n p<\/jats:italic>\n \u00a0<\u00a00.01). Compared with low tendency centers, medium tendency centers had an OR of 0.88 (95% CI: 0.76\u20131.01,\n p<\/jats:italic>\n \u00a0=\u00a00.07) and high tendency centers had an OR of 0.79 (95% CI: 0.67\u20130.91,\n p<\/jats:italic>\n \u00a0<\u00a00.01) for splenectomy.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n A significant variation exists among US trauma centers in the use of SAE for the management of isolated high\u2010grade BSI. Trauma centers with higher tendencies for SAE use were associated with lower splenectomy rates even after the adjustment of the use of SAE.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/wjs.70104","type":"journal-article","created":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T02:49:57Z","timestamp":1758336597000},"page":"3236-3241","source":"Crossref","is-referenced-by-count":1,"title":["Variation Among Trauma Centers in the Use of Angioembolization and Splenectomy Rate in Isolated High\u2010Grade Blunt Splenic Injuries"],"prefix":"10.1002","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8239-8822","authenticated-orcid":false,"given":"Makoto","family":"Aoki","sequence":"first","affiliation":[{"name":"Division of Traumatology National Defense Medical College Research Institute Tokorozawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2266-476X","authenticated-orcid":false,"given":"Yohei","family":"Okada","sequence":"additional","affiliation":[{"name":"Health Services and Systems Research Duke\u2010NUS Medical School National University of Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shokei","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Trauma and Emergency Surgery Saiseikai Yokohamashi Tobu Hospital Yokohama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morihiro","family":"Katsura","sequence":"additional","affiliation":[{"name":"Division of Acute Care Surgery Department of Surgery University of Southern California Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben L.","family":"Zarzaur","sequence":"additional","affiliation":[{"name":"Department of Surgery Division of Acute Care and Regional General Surgery University of Wisconsin\u2010Madison Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhide","family":"Matsushima","sequence":"additional","affiliation":[{"name":"Division of Acute Care Surgery Department of Surgery University of Southern California Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,19]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0039\u20106060(97)90070\u20102"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373\u2010200008000\u201000002"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/ta.0000000000003833"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2024.111707"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/ta.0b013e318224d0e4"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ams2.837"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/ta.0000000000000450"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/ta.0b013e3182988b3b"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4780100410"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/wjs.12238"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ta.0000241363.97619.d6"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.2010.58"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/sla.0000000000002246"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.135.6.674"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/000313481107700224"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/sla.0000000000003486"}],"container-title":["World 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