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Vol. 15 No. 3, March 2006
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AAP Grand Rounds 15:25-26 (2006)
© 2006 American Academy of Pediatrics

CRITICAL CARE

Management of Splenic Injuries Varies Between General and Children’s Hospitals

Source: Bowman SM, Zimmerman FJ, Christakis DA, et al. Hospital characteristics associated with the management of pediatric splenic injuries. JAMA. 2005;294:2611–2617.[Abstract/Free Full Text]

The first 20% of the full text of this article appears below.

Investigators from the University of Washington, Seattle, performed a retrospective cohort study of children (aged 0–16 years) with traumatic spleen injuries included in the 2000 Kids’ Inpatient Database (KID) to determine patient and hospital features associated with operative management. The KID is funded by the Agency for Healthcare Research and Quality and includes data from 27 participating states with 2.5 million pediatric hospital discharge records. Discharge records with International Classification of Diseases Ninth Revision (ICD9) codes documenting traumatic spleen injury were included for study. Procedure codes for splenectomy and hospital procedure day were also captured. Splenectomy that occurred the day of admission was defined as operative management, while later splenectomies were classified as failure of nonoperative management. Severity of illness was assessed using Injury Severity Scores (ISS),1 and massive splenic injury was defined as ICD9 code 865.04 or 865.14. Penetrating injuries were captured in part by E codes for firearms and knives.

. . . [Full Text of this Article]

Susan L. Bratton, MD, MPH, FAAP
Pediatric Critical Care Medicine, Primary Children’s Medical Center, University of Utah Health Sciences Center, Salt Lake City, UT

 






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