Age Should Not Be a Consideration for Nonoperative Management of Blunt Splenic Injury

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Abstract
Operative management of blunt splenic injury is recommended for adults ≥ 55 years. Because this is not our practice, we did a retrospective review to compare outcomes of patients ≥ 55 years old versus patients During a 5-year period ending in July of 1998, 461 patients (3%) admitted to our Level I trauma center had a blunt splenic injury. Eighty-six patients (19%) died within 24 hours of massive injuries, leaving 375 patients for evaluation. Data were obtained from our trauma registry and medical records. A total of 29 patients (8%) were ≥ 55 years old (mean age, 67 ± 2 years; mean injury severity score [ISS] 25 ± 2). Of these, 18 patients (62%) underwent nonoperative management (NOM). A total of 346 patients (92%) were Adults ≥ 55 years old with blunt splenic injury are successfully treated by NOM. Although older adults had significantly greater injuries, they had similar failure rates of NOM when compared with younger adults. Older adults had significantly higher mortality, but this was not a result of their splenic injury. Therefore, age should not be a criteria for NOM of blunt splenic injury.