Trauma to Liver and Spleen: Evaluating the Role of Transfusion and Associated Injuries in Treatment Outcomes

Abstract Background/Aim The liver and spleen are the most commonly injured solid organs in abdominal trauma. The impact of haemostatic resuscitation and additional injuries on treatment strategies and clinical outcomes remains to be elucidated. This multicentered study aims to address the knowledge gap and contribute to the literature by presenting the initial analysis data. Materials and Methods This retrospective observational study analyzed trauma patients with liver and spleen injuries admitted to participant hospitals in Turkey between January 1, 2019, and January 1, 2022. Only patients with liver and/or spleen injuries in the gastrointestinal system were included in the study design. Demographic, clinical, laboratory, radiology, and transfusion data were collected. Results A total of 242 patients were included, with a mean age of 36.2 ± 19.1 years, and 78% were male. Blunt and penetrating mechanisms comprised 86.4% and 13.6% of injuries. The overall non-operative management (NOM) rate was 74.4%, with a failure rate of 2.3% for the liver, 8.8% for the spleen, and 24.2% for combined liver and spleen injuries. Operative patients had higher transfusion rates (83.3% vs. 25.3%). Transfusion was associated with increased ICU and hospital length of stay (LOS). Mortality rates were higher in the operative group (66.7% vs. 33.3%), particularly in patients with additional head and thoracic injuries. Conclusion NOM remains the preferred treatment strategy for hemodynamically stabilized patients with liver and spleen trauma, demonstrating favorable outcomes with lower transfusion rates and shorter hospital stays. However, failure rates increase with higher-grade injuries and concomitant extra-abdominal trauma.