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There is no consensus regarding the optimal treatment of hemodynamically stable patients with grade IV and V blunt splenic injuries. In a retrospective analysis of multicenter trauma registry data for 2746 patients with such injuries, researchers used propensity matching to compare outcomes between those who underwent initial nonoperative management (NOM; 54%) and those who underwent splenectomy (46%) within 4 hours of emergency department arrival.
Infectious complications were more common in the splenectomy group (21.4% vs. 16.9%), whereas in-hospital mortality did not differ significantly between groups (11.5% vs. 10.0%). Approximately 20% of patients failed NOM; these patients, compared with those who underwent splenectomy, had lower in-h…