{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,8,5]],"date-time":"2024-08-05T18:33:28Z","timestamp":1722882808281},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,6,19]],"date-time":"2013-06-19T00:00:00Z","timestamp":1371600000000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Australian J Rural Health"],"published-print":{"date-parts":[[2013,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>There is paucity of research documenting the management of splenic injury in rural Australia. No data exists for Rural, Remote and Metropolitan Area 4 locations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A retrospective review of prospectively collected data. Records were additionally sought from transfer hospitals. A qualitative assessment of splenic trauma management in the Wimmera Region was also performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Wimmera Health Care Group: Horsham Campus, a Level 3 trauma hospital between January 2000 and July 2011.<\/jats:p><\/jats:sec><jats:sec><jats:title>Participants<\/jats:title><jats:p>Patients coded with injury of spleen or excision procedure on spleen.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interventions<\/jats:title><jats:p>Nil<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>surgical vs. non\u2010surgical management<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nineteen patients were included (mean age 27.8, range 8\u201354). Only 26% were from Horsham. Most injuries were due to sporting trauma\/falls (53%) and motor vehicle accidents (37%). One patient died in theatre from massive trauma. Eleven patients were managed non\u2010operatively. Seven patients had splenec\u2010 tomy performed. Four of these had delay in computed tomography scanning, delay to theatre and suffered major postoperative complication. The age (mean 39.9 versus 20.8) and Injury Severity Score (mean 21.9 versus 13.8) of patients requiring splenectomy was higher than those managed non\u2010operatively. Six of the splenic injury admissions (32%) were transferred from surrounding general practitioner\u2010run Rural, Remote and Metropolitan Area 5 hospitals. All of these patients had Victorian State Trauma Service\u2010defined major trauma with an Injury Severity Score &gt;15. There was an approximate 4\u2010hour delay in transfer of these patients, with transfer occurring when clinical deterioration occurred.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although splenic injury is uncommon in the Wimmera region, improved trauma triaging is required, with early transfer of unstable patients and high\u2010energy trauma mechanisms. A lower threshold for computed tomography scanning is recommended.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajr.12035","type":"journal-article","created":{"date-parts":[[2013,6,19]],"date-time":"2013-06-19T08:54:12Z","timestamp":1371632052000},"page":"163-169","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Splenic injury admitted to a rural <scp>L<\/scp>evel 3 trauma centre: A 10\u2010year audit"],"prefix":"10.1111","volume":"21","author":[{"given":"Wayne","family":"Hoskins","sequence":"first","affiliation":[{"name":"Department of Surgery Royal Melbourne Hospital  Parkville"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abraham","family":"Jacob","sequence":"additional","affiliation":[{"name":"Department of Surgery Royal Melbourne Hospital  Parkville"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shiran","family":"Wijeratne","sequence":"additional","affiliation":[{"name":"Department of Surgery Wimmera Health Care Group: Horsham Campus  Horsham Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian","family":"Campbell","sequence":"additional","affiliation":[{"name":"Department of Surgery Wimmera Health Care Group: Horsham Campus  Horsham Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Taylor","sequence":"additional","affiliation":[{"name":"Department of Surgery Royal Melbourne Hospital  Parkville"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,6,19]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.1994.tb02261.x"},{"key":"e_1_2_9_3_1","first-page":"490","article-title":"Management of splenic trauma at a rural, Level I trauma center","volume":"63","author":"Bianchi JD","year":"1997","journal-title":"The American Surgeon"},{"key":"e_1_2_9_4_1","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1177\/000313480907500817","article-title":"Management differences for pediatric solid organ injuries in a rural state","volume":"75","author":"Harbrecht BG","year":"2009","journal-title":"The American Surgeon"},{"key":"e_1_2_9_5_1","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1177\/000313481107700224","article-title":"Does splenic embolization and grade of splenic injury impact nonoperative management in patients sustaining blunt splenic trauma?","volume":"77","author":"Jeremitsky E","year":"2011","journal-title":"The American Surgeon"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005373-199503000-00001"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.TA.0000103988.66443.0E"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.134.12.1378"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/jpsu.2000.6948"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-011-0132-z"},{"key":"e_1_2_9_11_1","unstructured":"Regional and rural trauma services.State Government of Victoria.2010. 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