Pattern, Management, and Outcomes of Splenic Injuries at Kenyatta National Hospital: A Retrospective Cross-Sectional Study

Background: Traumatic splenic injury pattern and management determine its prognosis. In our context, management outcomes data are scarce. Objective: To determine the pattern, management, and outcomes among splenic trauma patients. Materials and methods: A retrospective cross-sectional study of patients aged 13 years and older with traumatic splenic injuries from January 2015 to December 2022 was conducted, and data were analyzed. Results: The study enrolled 95 patients with a mean age of 29.4±11.8 years. Most (87.4%) were men. Isolated splenic injuries were present in 54.5% (52) of 95 patients, with head and chest injuries being most common. Most patients (94.7%) had blunt injuries, and approximately 62% of blunt trauma patients had multiple injuries. Splenic injuries were largely caused by falls from height (23.2%) and road traffic accidents (62.1%). Of 95 patients, 51.6% underwent surgery, with splenectomy accounting for 93.9% of procedures. Grade III–V splenic injuries were observed in 63% of patients. American Association of Surgery for Trauma grade significantly affected splenic injury management (p = 0.01). The overall mortality rate was 5.3%. Polytrauma was associated with intensive care unit admission (p = 0.03) and longer hospital stays (p = 0.001). Conclusion: The most common cause of splenic injury was blunt trauma from car accidents. Most grade III splenic injuries required splenectomy. Patients with polytrauma stayed longer in the hospital. Surgery remains the mainstay for high-grade splenic injuries and polytrauma, although conservative therapy for these injuries is improving.