Risk factors for mortality among patients with splenic infarction in the emergency department.

Background: Splenic infarction is relatively uncommon with a mortality rate ranging from 5% to 34% reported in the literature. Research that focuses on this disease, particularly regarding its mortality risk factors, is scarce. This study aimed to identify the characteristics of splenic infarction and investigate risk factors for 30-day mortality in patients diagnosed with this disease in an emergency department (ED).

Methods: This retrospective cohort study utilized a computed tomography (CT) database search to identify adult patients who received their first diagnosis of splenic infarction via CT scan during ED visits at a Taiwanese medical center from January 2011 to December 2021. The study employed logistic regression analysis to identify prognostic factors for 30-day mortality.

Results: The study involved 73 patients with a median age of 71 years. ICU admission was required for 23.3% of patients, and the average hospital stay was 14 days. The 30-day mortality rate was 23.3%. Univariate logistic regression analysis revealed several mortality risk factors, including low hemoglobin level, diabetes mellitus, uremia requiring renal replacement therapy, active malignancy, high Taiwan Triage and Acuity Scale (TTAS) level, increased qSOFA score, along with high MEWS. Multivariate logistic regression analysis identified uremia requiring renal replacement therapy, active malignancy, and high TTAS level as independent predictors.

Conclusion: For ED patients with splenic infarction, the 30-day mortality rate was 23.3%. Independent predictors of mortality included uremia requiring renal replacement therapy, active malignancy, and high triage levels.