Management strategies of blunt hepatic and splenic trauma in austria: multicentre survey analysis

Management of hepatic and splenic injuries has evolved over the past 30 years. Non-operative management (NOM) rapidly gained standard of care. However, uncertainty still exists about patient selection and details of management as time to reinitiating oral intake, duration of restricted activity, or necessity of repeated imaging. This national multicentre questionnaire study aims to give a cross-sectional overview of current management of blunt liver and splenic trauma in Austrian hospitals. A multicentre questionnaire study was performed. Data collection involved electronic-based questionnaires comprised of questions examining the selection criteria for NOM and practical aspects of follow-up. The questionnaires were addressed to all Austrian surgical departments and trauma units. After three months, responses were electronically and anonymously recorded, data were analysed using descriptive statistics. In total, 60% response could be achieved, but 24 % completed the full questionnaire. A widespread shift to NOM could be observed. More than 70 % of injuries were treated conservatively. 40 % of hospitals actually follow a structured clinical algorithm. Further outcomes and details about the single questionnaire aspects will be presented. NOM is the standard of care for blunt hepatic and splenic injuries in Austria. In clinical relevant questions there is still a lack of consensus. Based on this experience, standard protocols may be generated for systematisation of care in blunt abdominal trauma.