477 Are We Managing Splenic Trauma Appropriately? Changes After Introduction of Major Trauma Centres

Published Date: 19th June 2025

Publication Authors: Reynolds. A, Bagade. N, Mathur. M, Kanwar. S

Aim
Trauma is one of the largest causes of mortality for patients under 40, with a significant proportion suffering with splenic trauma. To improve the management of traumas in hospitals and outcomes of these patients, Major Trauma Centers (MTC) were introduced in 2012 in the UK. This audit aimed to assess the management of patients with splenic trauma in a District General Hospital (DGH), within the Merseyside region, and to compare with data prior to the implementation of MTC.

Method
Retrospective cohort study performed, taking patients coded as 'splenic injury' between June 2020 and September 2023. The data was analysed for the following parameters: demographics, mechanism of injury, polytrauma, haemodynamic status, imaging, management, place of care. Data from previous audit cycle, between August 2002 and 2007, used for comparison.

Results
24 patients coded as ’splenic injury’, of those, 17 had splenic trauma. 7/17 (41%) patients were transferred to a MTC for further management. Of those not transferred (n=10) 3 were operated on (2 splenectomies and 1 embolisation), 5 managed conservatively, and 2 palliated. In comparison to previous audit cycle, there was a significant reduction in patients managed in ICU (2/10, 20%; 7/7, 100%), reduction in unexpected deaths (0/10, 0%; 2/7 20%), and an increase in number of CT performed (17/17, 100%; 5/7, 71%).

Conclusions
The implementation of MTC has shown a significant difference in the number of patients being treated at the DGH. The data collection from this study is consistent with the progression towards non-operative management and ward-based care of splenic trauma.

 

Reynolds. A; Bagade, N; Mathur, M; Kanwar, S. (2025). 477 Are We Managing Splenic Trauma Appropriately? Changes After Introduction of Major Trauma Centres. BJS. 112(Suppl 10), p.znaf128.451. [Online]. Available at: https://doi.org/10.1093/bjs/znaf128.451 [Accessed 1 August 2025]

 

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