{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,5]],"date-time":"2026-07-05T10:19:59Z","timestamp":1783246799427,"version":"3.54.6"},"reference-count":20,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T00:00:00Z","timestamp":1694044800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T00:00:00Z","timestamp":1694044800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T00:00:00Z","timestamp":1694044800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>This study aimed to compare patient outcomes after splenic angioembolization (SAE) or splenectomy for isolated severe blunt splenic injury (BSI) with hemodynamic instability, and to identify potential candidates for SAE.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Adult patients with isolated severe BSI (Abbreviated Injury Scale [AIS] 3\u20135) and hemodynamic instability between 2013 and 2019 were identified from the American College of Surgeons Trauma Quality Improvement (ACS TQIP) database. Hemodynamic instability was defined as an initial systolic blood pressure (SBP)\u2009&lt;90\u00a0mmHg, heart rate (HR)\u2009&gt;120 bpm, or lowest SBP\u2009&lt;90\u00a0mmHg within 1 h after admission, with\u2009\u22651 unit of blood transfused within 4 h after admission. In\u2010hospital mortality was compared between splenectomy and SAE groups using 2:1 propensity\u2010score matching. The characteristics of unmatched and matched splenectomy patients were also compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 478 patients met our inclusion criteria (332 splenectomy, 146 SAE). After propensity\u2010score matching, 166 splenectomy and 83 SAE patients were compared. Approximately 85% of propensity\u2010score matched patients sustained AIS 3\/4\u00a0injuries, and 50% presented with normal SBP and HR before becoming hemodynamically unstable. The median time to intervention (splenectomy or SAE) was 137\u00a0min (interquartile range 94\u2013183). In\u2010hospital mortality between splenectomy and SAE groups was not significantly different (5.4% vs. 4.8%, <jats:italic>p<\/jats:italic>\u2009=\u20091.000). More than half of unmatched patients in the splenectomy group sustained AIS 5\u00a0injuries and presented with initially unstable hemodynamics. The median time to splenectomy in such patients was significantly shorter than in matched splenectomy patients (67 vs. 132\u00a0min, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Splenectomy remains the mainstay of treatment for patients with AIS 5 BSI who present to hospital with hemodynamic instability. However, SAE might be a feasible alternative for patients with AIS 3\/4\u00a0injuries.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-023-07156-5","type":"journal-article","created":{"date-parts":[[2023,9,7]],"date-time":"2023-09-07T20:41:20Z","timestamp":1694119280000},"page":"2644-2650","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Angioembolization for Isolated Severe Blunt Splenic Injuries with Hemodynamic Instability: A Propensity Score Matched Analysis"],"prefix":"10.1002","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8239-8822","authenticated-orcid":false,"given":"Makoto","family":"Aoki","sequence":"first","affiliation":[{"name":"Advanced Medical Emergency Department and Critical Care Center Japan Red Cross Maebashi Hospital 371\u20100811 Maebashi Japan"}],"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":"Toshikazu","family":"Abe","sequence":"additional","affiliation":[{"name":"Department of Emergency and Critical Care Medicine Tsukuba Memorial Hospital Tsukuba Ibaraki Japan"},{"name":"Health Services Research and Development Center University of Tsukuba Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben L.","family":"Zarzaur","sequence":"additional","affiliation":[{"name":"Department of Surgery University of Wisconsin Madison WI 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 CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,9,7]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373\u2010200008000\u201000002"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000001323"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3182702afc"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13017\u2010017\u20100151\u20104"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373\u2010199511000\u201000004"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ta.0000223466.62589.d9"},{"issue":"3","key":"e_1_2_7_8_1","first-page":"565","article-title":"The effects of splenic artery embolization on nonoperative management of blunt splenic injury: a 16\u2010year experience","volume":"67","author":"Sabe AA","year":"2009","journal-title":"J Trauma"},{"issue":"1","key":"e_1_2_7_9_1","first-page":"44","article-title":"Angiography for blunt splenic trauma does not improve the success rate of nonoperative management","volume":"63","author":"Harbrecht BG","year":"2007","journal-title":"J Trauma"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000000782"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2020.3672"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000003833"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002246"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.3697"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.21037\/atm.2018.12.10"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2021.02.028"},{"key":"e_1_2_7_17_1","unstructured":"TanT LuoY HuJet al. 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Because of the anonymous and retrospective nature of the study, the need for informed consent was waived.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}