Race and insurance status outcome disparities following splenectomy in trauma patients are reduced in larger hospitals. A cross-sectional study

• Published in: Annals of medicine and surgery 2022-05, Vol.77, p.103516-103516, Article 103516
• Main Authors: Kaplan, Harrison J., Leitman, I. Michael
• Format: Article
• Language: English
• Subjects: Cross-sectional Study; Insurance; Race; Spleen; Splenectomy; Trauma
• ISSN: 2049-0801; 2049-0801
• DOI: 10.1016/j.amsu.2022.103516

Splenectomy, still a commonly performed treatment for splenic injury in trauma patients, has been shown to have a high rate of complications. The purpose of this study was to identify predictors, including race and insurance status, associated with adverse outcomes post-splenectomy in trauma patients. We discuss possible explanations and methods for reducing these disparities. The American College of Surgeons – Trauma Quality Improvement Program (ACS-TQIP) participant user database was queried from 2010 to 2015 and patients who underwent total splenectomy were identified. All mechanisms of injury, including both blunt and penetrating trauma, were included. Patients with advance directives limiting care or aged under 18 were excluded. Propensity score matching was used to control for age, preexisting medical conditions, and the severity of the traumatic injury. A chi-squared test was used to find significant associations between available predictors and outcomes for this cross-sectional study. The post-splenectomy mortality rate was 9.2% (n = 1047), 8.0% (n = 918) of patients had three or more complications, and 20.3% (n = 2315) had major complications. A primary race of white (OR 0.7, 95% Confidence Interval (CI) 0.6–0.9, p