30 - Embolization vs. Surgery in Splenic Trauma: A Severity-Adjusted Comparative Effectiveness Analysis

Sunday, April 12, 2026

4:21 PM - 4:30 PM ET

Presenting Author(s)

Mustafa Ege Seker, MD (he/him/his)

Research Fellow
University of Wisconsin-Madison, Department of Radiology, Section of Interventional Radiology, United States

Author/Co-author(s)

KS

Kristan Staudenmayer, MD, MS

Associate Professor of Surgery
Stanford University, Department of Surgery, Section of Trauma and Acute Care Surgery, United States
OO

Orhan Ozkan, MD

Chief, Vascular and Interventional Radiology
UW Hospital & Clinics, United States
DD

Dania Daye, MD, PhD

Associate Professor
Massachusetts General Hospital/Harvard Medical School, United States
Nishita Kothary, MD

Professor of Radiology
Stanford University School of Medicine, United States

Purpose: To compare effectiveness of embolization and surgery in patients with splenic trauma.

Materials and Methods: A total of 8856 adult splenic injury patients from American College of Surgeons’ Trauma Quality Improvement Program (2021-2023) were included. Patients who underwent embolization (n=2002) and surgery (n=6854) were propensity score matched (PSM) using age and sex. Groups were compared with Mann–Whitney U test for numerical variables and chi-squared test for categorical variables. Length of stay (LoS) with abbreviated injury scale (AIS) stratification was analyzed with linear regression. Logistic regression models were used to analyze mortality and unplanned intensive care unit (ICU) admission with AIS stratification.

Results: Following PSM 2002 patients from each group were matched successfully. There were 1344 (67.1%) females and 658 (32.9%) males in embolization group and 1340 (66.9%) females and 662 (33.1%) in surgery group (P = .91). The median (IQR) age was 44.5 (31) for embolization group and 44 (31) for surgery group (P = 1). LoS (9[10]-12[16]), unplanned ICU admission rates (78[3.9%]-125[6.2%]) and mortality (129[6.3%]-353[17.6%]) were significantly different for embolization and surgery groups (All P < .001). LoS was significantly lower for embolization group with AIS stratification (P < .001). Unplanned ICU admission rates were significantly lower for embolization group with AIS stratification (P = .003, .03, .01; All, 3 and 5 respectively) except AIS 4 was nonsignificant (P = .94). Mortality was significantly lower for embolization group with AIS stratification (P < .001, .01, .001, .001; All, 3, 4 and 5 respectively).

Conclusion: Embolization is associated with better results compared to surgery for splenic trauma patients from national trauma registry when severity is adjusted, leading to significantly lower rates of mortality, unplanned ICU admissions, and shorter hospital stays.