Grade III blunt splenic injury without contrast extravasation - World Society of Emergency Surgery Nijmegen consensus practice
Abstract Background Recent trauma guidelines recommend non-operative management for grade III splenic injury without contrast extravasation on computed tomography. Nevertheless, such recommendations rely on low-quality evidence, and practice variation characterizes clinical management for this type...
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| Format: | Article |
| Language: | English |
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BMC
2020-08-01
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| Series: | World Journal of Emergency Surgery |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13017-020-00319-y |
| _version_ | 1818541928099086336 |
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| author | Francesco Amico Rebecca Anning Cino Bendinelli Zsolt J. Balogh Participants of the 2019 World Society of Emergency Surgery (WSES) Nijmegen splenic injury collaboration group. |
| author_facet | Francesco Amico Rebecca Anning Cino Bendinelli Zsolt J. Balogh Participants of the 2019 World Society of Emergency Surgery (WSES) Nijmegen splenic injury collaboration group. |
| author_sort | Francesco Amico |
| collection | DOAJ |
| description | Abstract Background Recent trauma guidelines recommend non-operative management for grade III splenic injury without contrast extravasation on computed tomography. Nevertheless, such recommendations rely on low-quality evidence, and practice variation characterizes clinical management for this type of injury. We aimed to identify the role of eleven selected clinical factors influencing the management of grade III splenic injury without contrast extravasation by expert consensus and a modified Delphi approach. Methods A questionnaire was developed with the endorsement of the World Society of Emergency Surgery (WSES). This was delivered and answered live by acute care surgeons attending the 6th WSES congress in Nijmegen in 2019. A dedicated mobile phone application was utilized to collect the answers. All answers were evaluated for areas of discrepancy with an 80% threshold for consensus between respondents. Results Three factors generated discrepancy in opinion for managing this pattern of injury: the patients’ injury severity, the presence of a bleeding diathesis, and an associated intra-abdominal injury. Agreement was obtained for the other eight factors. Conclusion Researchers should focus their efforts on the identified area of discrepancy. Clinicians should use additional care in the presence of the three factors for which discordant opinions were found. |
| first_indexed | 2024-12-11T22:15:32Z |
| format | Article |
| id | doaj.art-94918803fc8b43a2b048a39a4b0d9a5d |
| institution | Directory Open Access Journal |
| issn | 1749-7922 |
| language | English |
| last_indexed | 2024-12-11T22:15:32Z |
| publishDate | 2020-08-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Emergency Surgery |
| spelling | doaj.art-94918803fc8b43a2b048a39a4b0d9a5d2022-12-22T00:48:37ZengBMCWorld Journal of Emergency Surgery1749-79222020-08-011511710.1186/s13017-020-00319-yGrade III blunt splenic injury without contrast extravasation - World Society of Emergency Surgery Nijmegen consensus practiceFrancesco Amico0Rebecca Anning1Cino Bendinelli2Zsolt J. Balogh3Participants of the 2019 World Society of Emergency Surgery (WSES) Nijmegen splenic injury collaboration group.Department of Traumatology, John Hunter HospitalDepartment of Surgery, John Hunter HospitalDepartment of Traumatology, John Hunter HospitalDepartment of Traumatology, John Hunter HospitalAbstract Background Recent trauma guidelines recommend non-operative management for grade III splenic injury without contrast extravasation on computed tomography. Nevertheless, such recommendations rely on low-quality evidence, and practice variation characterizes clinical management for this type of injury. We aimed to identify the role of eleven selected clinical factors influencing the management of grade III splenic injury without contrast extravasation by expert consensus and a modified Delphi approach. Methods A questionnaire was developed with the endorsement of the World Society of Emergency Surgery (WSES). This was delivered and answered live by acute care surgeons attending the 6th WSES congress in Nijmegen in 2019. A dedicated mobile phone application was utilized to collect the answers. All answers were evaluated for areas of discrepancy with an 80% threshold for consensus between respondents. Results Three factors generated discrepancy in opinion for managing this pattern of injury: the patients’ injury severity, the presence of a bleeding diathesis, and an associated intra-abdominal injury. Agreement was obtained for the other eight factors. Conclusion Researchers should focus their efforts on the identified area of discrepancy. Clinicians should use additional care in the presence of the three factors for which discordant opinions were found.http://link.springer.com/article/10.1186/s13017-020-00319-yTraumaSpleenInjuryBluntGrade IIIWSES |
| spellingShingle | Francesco Amico Rebecca Anning Cino Bendinelli Zsolt J. Balogh Participants of the 2019 World Society of Emergency Surgery (WSES) Nijmegen splenic injury collaboration group. Grade III blunt splenic injury without contrast extravasation - World Society of Emergency Surgery Nijmegen consensus practice World Journal of Emergency Surgery Trauma Spleen Injury Blunt Grade III WSES |
| title | Grade III blunt splenic injury without contrast extravasation - World Society of Emergency Surgery Nijmegen consensus practice |
| title_full | Grade III blunt splenic injury without contrast extravasation - World Society of Emergency Surgery Nijmegen consensus practice |
| title_fullStr | Grade III blunt splenic injury without contrast extravasation - World Society of Emergency Surgery Nijmegen consensus practice |
| title_full_unstemmed | Grade III blunt splenic injury without contrast extravasation - World Society of Emergency Surgery Nijmegen consensus practice |
| title_short | Grade III blunt splenic injury without contrast extravasation - World Society of Emergency Surgery Nijmegen consensus practice |
| title_sort | grade iii blunt splenic injury without contrast extravasation world society of emergency surgery nijmegen consensus practice |
| topic | Trauma Spleen Injury Blunt Grade III WSES |
| url | http://link.springer.com/article/10.1186/s13017-020-00319-y |
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