Analysis of the need for surgery for different anatomical locations of splenic injury and radiologic intervention.

The splenic surface can be anatomically divided into the visceral surface connected to major blood vessels and the diaphragmatic surface attached to the diaphragm. This study aimed to investigate differences in future treatment and outcomes according to the anatomical location of splenic injuries following abdominal trauma. Patients who were treated at a single trauma center between January 2011 and April 2018 were included. The presence of lacerations or hematoma on the visceral surface was evaluated via computed tomography. Differences in the location of splenic surgery between a group that underwent surgical or radiologic intervention and a group that received conservative care only were analyzed. Of 355 patients with splenic injury analyzed, the total mortality rate was 15.2%. A total of 167 patients underwent surgery and angiographic embolization, and 168 received conservative care only. Splenic injuries involved the visceral surface in 127 and 105 patients in the respective groups. Significant differences in the incidence of splenic injuries involving the visceral surface were found between the two groups in the univariate and logistic regression analyses. The likelihood of needing surgery and treatments such as embolization was higher for cases of splenic injury involving the visceral surface than for splenic injuries that did not involve the visceral surface. Through additional research, it may become possible to analyze the location of a splenic injury to determine an effective and safe method of treatment and accurately predict a prognosis. Clin. Anat. 33:516-521, 2020. © 2019 Wiley Periodicals, Inc.

Erratum: Correction of Author Order: Reduced Mortality by Physician-Staffed HEMS Dispatch for Adult Blunt Trauma Patients in Korea.

This corrects the article on p. 1656 in vol. 31, PMID: 27550497.

Reduced Mortality by Physician-Staffed HEMS Dispatch for Adult Blunt Trauma Patients in Korea.

The aim of this study was to investigate the efficiency of domestic physician-staffed helicopter emergency medical service (HEMS) for the transport of patients with severe trauma to a hospital. The study included patients with blunt trauma who were transported to our hospital by physician-staffed HEMS (Group P; n = 100) or nonphysician-staffed HEMS (Group NP; n = 80). Basic patient characteristics, transport time, treatment procedures, and medical treatment outcomes assessed using the Trauma and Injury Severity Score (TRISS) were compared between groups. We also assessed patients who were transported to the hospital within 3 h of injury in Groups P (Group P3; n = 50) and NP (Group NP3; n = 74). The severity of injury was higher, transport time was longer, and time from hospital arrival to operation room transfer was shorter for Group P than for Group NP (P < 0.001). Although Group P patients exhibited better medical treatment outcomes compared with Group NP, the difference was not statistically significant (P = 0.134 vs. 0.730). However, the difference in outcomes was statistically significant between Groups P3 and NP3 (P = 0.035 vs. 0.546). Under the current domestic trauma patient transport system in South Korea, physician-staffed HEMS are expected to increase the survival of patients with severe trauma. In particular, better treatment outcomes are expected if dedicated trauma resuscitation teams actively intervene in the medical treatment process from the transport stage and if patients are transported to a hospital to receive definitive care within 3 hours of injury.