eP60 Management of splenic trauma at Aintree University Hospital: an audit

Introduction Damage of the spleen can result in haemorrhage and life-threatening haemodynamic instability. This study aimed to evaluate the management of traumatic splenic injury at a major trauma centre against current international guidelines, and identify areas of good practice and areas for improvement. Methods Data was obtained from an existing data set of trauma patients presenting between 2018-2022. Patients with splenic injury confirmed on CT scan were included. Electronic and scanned notes were reviewed for data collection, and results were analysed. Standards included:80% of patients received CT/FAST scan100% of patients receiving correct grading of their splenic injury according to American Association for Surgery of Trauma (AAST) guidelines.100% of patients received correct treatment based upon the World Society of Emergency Surgery guidelines. Results All patients underwent CT scan (n=115). 73% received AAST grading, of whom 93% were graded correctly. 64% had non operative management in the form of conservative management and/or interventional radiological embolization. 37% underwent operative management. 5% failed conservative management and required surgery. 37% were managed according to WSES guidelines. Management was undetermined in 27% due to lack of AAST grading. Patients with WSES III and IV had a lower adherence to management (40% and 43% respectively) versus WSES I and II. Conclusion This audit highlights the variability in current guideline adherence and applicability for the management of splenic trauma. Intervention, education, and re-audit are required to improve patient outcomes.