The NOM failure rate in this study was 34.5% for patients with grade IV and 60% for grade V injury, comparing favorably with the failure rate of 33.3% for grade IV and 75% for grade V reported in the Eastern Association for the Surgery of Trauma (EAST) multi-institutional study1 in 2000.
In this study grade V splenic injury and brain injury were independent predictors of failure of NOM, and contrast extravasation and brain injury were associated with increased length of stay, morbidity, and trend toward increased mortality.
Kirton OC. Preservation of the Most Severely Injured Spleen: Is There Anything New?Comment on “Management of the Most Severely Injured Spleen”. Arch Surg. 2010;145(5):460-461. doi:10.1001/archsurg.2010.66