TIME TO SPLENIC ANGIOEMBOLIZATION DOES NOT IMPACT SPLENIC SALVAGE RATES

Objectives: Splenic angioembolization (SAE) improves splenic salvage after blunt splenic injury. Early SAE is thought to improve success, particularly in higher grade injuries. This study investigated whether early SAE improves outcome.

Methods: Retrospective review at a high-volume trauma center was performed on all patients who underwent SAE after sustaining blunt splenic trauma (Grades II-V) from 2016-2021. Patients were divided into early ( < 6 h) versus delayed (> 6 hours) SAE groups. The primary outcome was rate of splenic salvage by group. Additional evaluation was performed for mean time to embolization by success versus failure of splenic salvage. All analyses were performed using STATA/BE 17.0.

Results: Amongst 225 individuals, 76 (33.7%) were in the early group and 149 (66.2%) were in the delayed group. The early group was more likely to have a higher injury grade and greater volume of hemoperitoneum on admission Computed Tomography (CT) [Table]. Overall rate of delayed splenectomy was 16 (7.1%), with 9 (11.8%) in the early group and 7 (4%) in the delayed group. On univariate analysis, the early group had a 2.7x greater odds of delayed splenectomy (p < 0.05). Multivariable regression analysis accounting for splenic injury grade, Injury Severity Score, and amount of hemoperitoneum, however, did not demonstrate an association between early angioembolization and need for delayed splenectomy. Mean time to embolization was 21.5 and 16.6 hours respectively when successful SAE was compared to failed SAE (p>0.05).

Conclusion: Despite earlier SAE in patients with higher grade of splenic injury, they experienced higher rates of splenectomy compared to those undergoing delayed SAE. Timing of SAE may not predict outcome, but prospective validation is needed.