Early Ambulation Does Not Affect Outcomes in Patients with Low-Grade (Grade I–II) Splenic Lacerations or Hematomas

Abstract

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Follow-up strategies for patients with splenic trauma managed non-operatively: the 2022 World Society of Emergency Surgery consensus document

“…According to the authors, the timing of mobilization of patients with blunt solid organ injuries does not seem to contribute to delayed hemorrhage requiring laparotomy, as demonstrated by the fact that day of mobilization was not associated with delayed splenic rupture in multivariate analysis. Griffard et al [ 23 ] evaluated the safety, in terms of risk of delayed hemorrhage and subsequent failure of NOM, and complications of early ambulation within 24 h in low-grade splenic trauma to assess the length of stay, development of pneumonia, pleural effusions, VTE, and PE. In this study, of the 163 total patients, 100 (61.3%) were on bed rest for at least 24 h after their injury, and 63 (38.7%) were ambulated within the first 24 h. In the group of patients allowed to ambulate during the first 24 h, there were no failures of NOM, whereas, in those for those who bed rest for at least 1 day was prescribed, 6 (6%) failed NOM.…”

“…Our systematic review of the literature regarding this topic retrieved seven studies, of which four were conducted in the pediatric population [19][20][21][22], and three in the adult population [17,23,24]. Two were prospective cohort studies [19,20], five were retrospectives [5,17,21,23,24], and one was a systematic review of the literature [22].…”

“…According to the authors, the timing of mobilization of patients with blunt solid organ injuries does not seem to contribute to delayed hemorrhage requiring laparotomy, as demonstrated by the fact that day of mobilization was not associated with delayed splenic rupture in multivariate analysis. Griffard et al [23] evaluated the Research Question: 6. Is there a need for radiological follow-up during the hospital stay for patients treated with NOM for splenic trauma according to the injury grade?…”

“…22 Department of General and Thoracic Surgery, University Hospital of Giessen, Giessen, Germany. 23 Unit of General Surgery, Henri Mondor Hospital, UPEC, Créteil, France. 24 Service de Chirurgie Digestive, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France.…”