Risk factors for splenic injury during colectomy: A matched case-control study

Jeffrey K. Wang, Stefan D. Holubar, Bruce G. Wolff, Barbara Follestad, Megan M. O'Byrne, Rui Qin

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Purpose: We assessed risk factors for splenic injury during colectomy and associated outcomes for a 15-year period at a single institution. Methods: All adult general surgery patients who sustained a splenic injury during colectomy at our institution from 1992 to 2007 were retrospectively identified and matched 1:1 to controls without splenic injury. Putative risk factors were assessed using paired univariate analysis and conditional logistic regression. Differences in short- and long-term mortality were assessed using the log-rank test. Results are reported as a proportion, median, or odds ratio [OR (95% confidence intervals)]. Results: A total of 118 patients were included: 59 patients with splenic injury and 59 control patients. Statistically significant risk factors for splenic injury during colectomy found on univariate analysis included: splenic flexure mobilization, OR 21.00 (2.82-156.12); Charlson comorbidity index ≥ 5, OR 3.17 (1.26-7.93); ASA class ≥ 3, OR 5.33 (1.55-18.3); and nonelective surgery, OR 5.00 (1.1-22.82). On multivariate analysis, only splenic flexure mobilization was independently associated with increased risk of splenic injury (OR 18.4 (2.1-161); p = 0.0085). Splenic injured patients trended toward decrease survival both at 30 days (98 vs. 88%; p = 0.06) and at 5 years (58 vs. 55%), with a hazard ratio of 1.6 (1.0, 2.6; p = 0.05). Conclusions: Splenic flexure mobilization is the primary risk factor for splenic injury during colectomy, independent of other factors, such as higher ASA class, Charlson score, and nonelective surgery. Splenic injury during colectomy has an increased risk of death in both the short- and long-term.

Original languageEnglish (US)
Pages (from-to)1123-1129
Number of pages7
JournalWorld Journal of Surgery
Volume35
Issue number5
DOIs
StatePublished - May 2011

Fingerprint

Colectomy
Case-Control Studies
Wounds and Injuries
Transverse Colon
Comorbidity
Multivariate Analysis
Logistic Models
Odds Ratio
Confidence Intervals
Survival
Mortality

ASJC Scopus subject areas

  • Surgery

Cite this

Wang, J. K., Holubar, S. D., Wolff, B. G., Follestad, B., O'Byrne, M. M., & Qin, R. (2011). Risk factors for splenic injury during colectomy: A matched case-control study. World Journal of Surgery, 35(5), 1123-1129. https://doi.org/10.1007/s00268-011-0994-x

Risk factors for splenic injury during colectomy : A matched case-control study. / Wang, Jeffrey K.; Holubar, Stefan D.; Wolff, Bruce G.; Follestad, Barbara; O'Byrne, Megan M.; Qin, Rui.

In: World Journal of Surgery, Vol. 35, No. 5, 05.2011, p. 1123-1129.

Research output: Contribution to journalArticle

Wang, JK, Holubar, SD, Wolff, BG, Follestad, B, O'Byrne, MM & Qin, R 2011, 'Risk factors for splenic injury during colectomy: A matched case-control study', World Journal of Surgery, vol. 35, no. 5, pp. 1123-1129. https://doi.org/10.1007/s00268-011-0994-x
Wang JK, Holubar SD, Wolff BG, Follestad B, O'Byrne MM, Qin R. Risk factors for splenic injury during colectomy: A matched case-control study. World Journal of Surgery. 2011 May;35(5):1123-1129. https://doi.org/10.1007/s00268-011-0994-x
Wang, Jeffrey K. ; Holubar, Stefan D. ; Wolff, Bruce G. ; Follestad, Barbara ; O'Byrne, Megan M. ; Qin, Rui. / Risk factors for splenic injury during colectomy : A matched case-control study. In: World Journal of Surgery. 2011 ; Vol. 35, No. 5. pp. 1123-1129.
@article{b9eb2ad2585d43d693878f91620cfbac,
title = "Risk factors for splenic injury during colectomy: A matched case-control study",
abstract = "Purpose: We assessed risk factors for splenic injury during colectomy and associated outcomes for a 15-year period at a single institution. Methods: All adult general surgery patients who sustained a splenic injury during colectomy at our institution from 1992 to 2007 were retrospectively identified and matched 1:1 to controls without splenic injury. Putative risk factors were assessed using paired univariate analysis and conditional logistic regression. Differences in short- and long-term mortality were assessed using the log-rank test. Results are reported as a proportion, median, or odds ratio [OR (95{\%} confidence intervals)]. Results: A total of 118 patients were included: 59 patients with splenic injury and 59 control patients. Statistically significant risk factors for splenic injury during colectomy found on univariate analysis included: splenic flexure mobilization, OR 21.00 (2.82-156.12); Charlson comorbidity index ≥ 5, OR 3.17 (1.26-7.93); ASA class ≥ 3, OR 5.33 (1.55-18.3); and nonelective surgery, OR 5.00 (1.1-22.82). On multivariate analysis, only splenic flexure mobilization was independently associated with increased risk of splenic injury (OR 18.4 (2.1-161); p = 0.0085). Splenic injured patients trended toward decrease survival both at 30 days (98 vs. 88{\%}; p = 0.06) and at 5 years (58 vs. 55{\%}), with a hazard ratio of 1.6 (1.0, 2.6; p = 0.05). Conclusions: Splenic flexure mobilization is the primary risk factor for splenic injury during colectomy, independent of other factors, such as higher ASA class, Charlson score, and nonelective surgery. Splenic injury during colectomy has an increased risk of death in both the short- and long-term.",
author = "Wang, {Jeffrey K.} and Holubar, {Stefan D.} and Wolff, {Bruce G.} and Barbara Follestad and O'Byrne, {Megan M.} and Rui Qin",
year = "2011",
month = "5",
doi = "10.1007/s00268-011-0994-x",
language = "English (US)",
volume = "35",
pages = "1123--1129",
journal = "Presentations from the 9th Annual Electric Utilities Environmental Conference",
issn = "0364-2313",
publisher = "Springer New York",
number = "5",

}

TY - JOUR

T1 - Risk factors for splenic injury during colectomy

T2 - A matched case-control study

AU - Wang, Jeffrey K.

AU - Holubar, Stefan D.

AU - Wolff, Bruce G.

AU - Follestad, Barbara

AU - O'Byrne, Megan M.

AU - Qin, Rui

PY - 2011/5

Y1 - 2011/5

N2 - Purpose: We assessed risk factors for splenic injury during colectomy and associated outcomes for a 15-year period at a single institution. Methods: All adult general surgery patients who sustained a splenic injury during colectomy at our institution from 1992 to 2007 were retrospectively identified and matched 1:1 to controls without splenic injury. Putative risk factors were assessed using paired univariate analysis and conditional logistic regression. Differences in short- and long-term mortality were assessed using the log-rank test. Results are reported as a proportion, median, or odds ratio [OR (95% confidence intervals)]. Results: A total of 118 patients were included: 59 patients with splenic injury and 59 control patients. Statistically significant risk factors for splenic injury during colectomy found on univariate analysis included: splenic flexure mobilization, OR 21.00 (2.82-156.12); Charlson comorbidity index ≥ 5, OR 3.17 (1.26-7.93); ASA class ≥ 3, OR 5.33 (1.55-18.3); and nonelective surgery, OR 5.00 (1.1-22.82). On multivariate analysis, only splenic flexure mobilization was independently associated with increased risk of splenic injury (OR 18.4 (2.1-161); p = 0.0085). Splenic injured patients trended toward decrease survival both at 30 days (98 vs. 88%; p = 0.06) and at 5 years (58 vs. 55%), with a hazard ratio of 1.6 (1.0, 2.6; p = 0.05). Conclusions: Splenic flexure mobilization is the primary risk factor for splenic injury during colectomy, independent of other factors, such as higher ASA class, Charlson score, and nonelective surgery. Splenic injury during colectomy has an increased risk of death in both the short- and long-term.

AB - Purpose: We assessed risk factors for splenic injury during colectomy and associated outcomes for a 15-year period at a single institution. Methods: All adult general surgery patients who sustained a splenic injury during colectomy at our institution from 1992 to 2007 were retrospectively identified and matched 1:1 to controls without splenic injury. Putative risk factors were assessed using paired univariate analysis and conditional logistic regression. Differences in short- and long-term mortality were assessed using the log-rank test. Results are reported as a proportion, median, or odds ratio [OR (95% confidence intervals)]. Results: A total of 118 patients were included: 59 patients with splenic injury and 59 control patients. Statistically significant risk factors for splenic injury during colectomy found on univariate analysis included: splenic flexure mobilization, OR 21.00 (2.82-156.12); Charlson comorbidity index ≥ 5, OR 3.17 (1.26-7.93); ASA class ≥ 3, OR 5.33 (1.55-18.3); and nonelective surgery, OR 5.00 (1.1-22.82). On multivariate analysis, only splenic flexure mobilization was independently associated with increased risk of splenic injury (OR 18.4 (2.1-161); p = 0.0085). Splenic injured patients trended toward decrease survival both at 30 days (98 vs. 88%; p = 0.06) and at 5 years (58 vs. 55%), with a hazard ratio of 1.6 (1.0, 2.6; p = 0.05). Conclusions: Splenic flexure mobilization is the primary risk factor for splenic injury during colectomy, independent of other factors, such as higher ASA class, Charlson score, and nonelective surgery. Splenic injury during colectomy has an increased risk of death in both the short- and long-term.

UR - http://www.scopus.com/inward/record.url?scp=79955703041&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79955703041&partnerID=8YFLogxK

U2 - 10.1007/s00268-011-0994-x

DO - 10.1007/s00268-011-0994-x

M3 - Article

C2 - 21327837

AN - SCOPUS:79955703041

VL - 35

SP - 1123

EP - 1129

JO - Presentations from the 9th Annual Electric Utilities Environmental Conference

JF - Presentations from the 9th Annual Electric Utilities Environmental Conference

SN - 0364-2313

IS - 5

ER -