Splenic Angioembolization Does Not Benefit Elderly Patients

Background: Although the likelihood of successful nonoperative management (NOM) of splenic injury for the elderly is similar to nonelderly patients, the role of splenic angioembolization (SAE) in the elderly is poorly understood. Objective: To test the hypothesis that SAE would confer no benefit in elderly trauma patients undergoing NOM. Methods: Patients aged ≥15 years in the 2019-to-2022 Trauma Quality Improvement Program (TQIP) database presenting to level 1 or 2 trauma centers with splenic trauma were stratified into adult (15 to 64 years) and elderly (≥65 years) cohorts. Patients with missing key demographic, ED disposition, or procedure data were excluded, as were those who died in the ED, had non-survivable injuries, or who received SAE after splenic procedures. Patients were categorized based on clinical management strategies as splenectomy, NOM-success, NOM-failure, or other operative approach. SAE was considered an independent procedure. NOM-failure was defined as ED more...