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Table 2 Summary table of articles that met inclusion criteria after initial selection. Articles marked in bold were excluded

From: Splenic artery embolization: technically feasible but not necessarily advantageous

  Reference Study design Sample size and sites Comments/key findings Included/excluded
1 A.P. E, B. I, M. R, M.C. M. The impact of splenic artery embolization on the management of splenic trauma: an 8-year review. Am J Surg. 2009 Retrospective study 304 + 416
Single center
4 years NOM versus 4 years NOM + SAE Included
2 Akinkuolie AA, Lawal OO, Arowolo OA, Agbakwuru EA, Adesunkanmi ARK. Determinants of splenectomy in splenic injuries following blunt abdominal trauma. SOUTH AFRICAN J Surg . 2010 Retrospective study 55
Single center
Poor overall quality, 1998–2007, small study group Excluded
3 Albrecht RM, Schermer CR, Morris A. Nonoperative management of blunt splenic injuries: factors influencing success in age >55 years. Am Surg . 2002 Retrospective study 37
Single center
Small study group Excluded
4 Bala M, Edden Y, Mintz Y, et al. Blunt splenic trauma: Predictors for successful non-operative management. Isr Med Assoc J . 2007 Prospective study 64
Single center
Admission systolic bloodpressure, extra-abdominal injury are predictors for succesfull NOM, small study group Excluded
5 Barquist ES, Pizano LR, Feuer W, et al. Inter- and intrarater reliability in computed axial tomographic grading of splenic injury: Why so many grading scales? J TRAUMA-INJURY Infect Crit CARE. 2004 Retrospective study 200
Single center
200 CT images were reviewed for inter- and intrarater reliability Included
6 Benissa N, Boufettal R, Kadiri Y, et al. Non operative management of blunt splenic trauma in adults. J Chir (Paris) . 2008 Retrospective study 62
Single center
Overall poor quality paper Excluded
7 Bhangu A, Nepogodiev D, Lal N, Bowley DM. Meta-analysis of predictive factors and outcomes for failure of non-operative management of blunt splenic trauma. Inj J CARE Inj . 2012 Meta-analysis   Meta-analysis Excluded
8 Brillantino A, Iacobellis F, Robustelli U, et al. Non operative management of blunt splenic trauma: a prospective evaluation of a standardized treatment protocol. Eur J Trauma Emerg Surg . September 2015 Prospective 87 No full text available, epub ahead of print Excluded
9 Brugère C, Arvieux C, Dubuisson V, et al. Early embolisation in non-operative management of blunt splenic injuries: a retrospective multicentric study. J Chir (Paris) . 2008 Retrospective multicentric study 22 Full text no longer available, Use of Moore clasification, low power Excluded
10 C. R, A. A, G.P. S, et al. Management of splenic trauma: a single institution’s 8-year experience. Am J Surg. 2015 Retrospective registry review 926   Included
11 Chastang L, Bège T, Prudhomme M, et al. Is non-operative management of severe blunt splenic injury safer than embolization or surgery? Results from a French prospective multicenter study. J Chir Viscerale. 2015 Prospective multicentric study 91   Included
12 Clancy AA, Tiruta C, Ashman D, Ball CG, Kirkpatrick AW. The song remains the same although the instruments are changing: complications following selective nonoperative management of blunt spleen trauma: A retrospective review of patients at a level I trauma centre from 1996 to 2007 Retrospective 538 Single center study from 1996–2007, lack of data and statistical analysis Excluded
13 Claridge JA, Carter JW, McCoy AM, Malangoni MA. In-house direct supervision by an attending is associated with differences in the care of patients with a blunt splenic injury. Surgery. 2011 Retrospective review 506   Included
14 Cohn SM, Arango JI, Myers JG, et al. Computed Tomography Grading Systems Poorly Predict the Need for Intervention after Spleen and Liver Injuries. Am Surg. 2009   300   Included
15 Cooney R, Ku J, Cherry R, et al. Limitations of splenic angioembolization in treating blunt splenic injury. J Trauma - Inj Infect Crit Care. 2005 Retrospective 194   Included
16 D. D, G. A, B.A. E, et al. Blunt splenic injuries: High nonoperative management rate can be achieved with selective embolization. J Trauma - Inj Infect Crit Care. 2004 Retrospective study 233 + 168   Included
17 D.C. O, J.S.K. L, P.P. DR, et al. Variation in treatment of blunt splenic injury in Dutch academic trauma centers. J Surg Res. 2015 Retrospective study 253   Included
18 Dehli T, Bagenholm A, Trasti NC, et al. The treatment of spleen injuries: a retrospective study. Scand J TRAUMA Resusc Emerg Med. 2015 Retrospective study 109 More splenic salvage after introduction of SAE Included
19 Ekeh AP, Khalaf S, Ilyas S, et al. Complications arising from splenic artery embolization: A review of an 11-year experience. Am J Surg. 2013 Retrospective study 1383   Included
20 Ekeh AP, McCarthy MC, Woods RJ, et al. Complications arising from splenic embolization after blunt splenic trauma. Am J Surg . 2005 Retrospective study 284 More recent studies were used. Excluded
21 Fu C-Y, Wu S-C, Chen R-J, et al. Evaluation of need for operative intervention in blunt splenic injury: intraperitoneal contrast extravasation has an increased probability of requiring operative intervention. World J Surg. 2010 Retrospective study 69   Included
22 G. T, E. B, A. B, et al. Nonoperative management of blunt splenic injury in adults: there is (still) a long way to go. The results of the Bologna-Maggiore Hospital trauma center experience and development of a clinical algorithm. Surg Today. 2015 Retrospective study 293 Development of a BSI protocol Included
23 Gaarder C, Dormagen JB, Eken T, et al. Nonoperative management of splenic injuries: improved results with angioembolization. J Trauma. 2006 Prospective study compared to historic control group 61 + 64 Results after protocol implementation Included
24 Gonzalez M, Bucher P, Ris F, Andereggen E, Morel P. Splenic trauma: predictive factors for failure of non-operative management. J Chir (Paris). 2008 Retrospective study 190 Predictive factors Included
25 Haan JM, Biffl W, Knudson MM, et al. Splenic Embolization Revisited: A Multicenter Review. J Trauma - Inj Infect Crit Care. 2004 Retrospective multicentric study 140 Complications SAE Included
26 Hsieh T-M, Tsai TC, Liang J-L, Lin CC. Non-operative management attempted for selective high grade blunt hepatosplenic trauma is a feasible strategy. WORLD J Emerg Surg . 2014 Retrospective study 150 Hepatosplenic group Excluded
27 J. F, M. R, C. A, et al. Blunt splenic injury: are early adverse events related to trauma, nonoperative management, or surgery? DIAGNOSTIC Interv Radiol. 2015 Retrospective study 136 OM worse outcomes but related to ISS Included
28 J. S, T.L. T, J.B. D, et al. Preserved splenic function after angioembolisation of high grade injury. Injury. 2012 Retrospective study 58   Included
29 K.K. T, M.T. C, A. V, Tan KK, Chiu MT, Vijayan A. Management of isolated splenic injuries after blunt trauma: An institution’s experience over 6 years. Med J Malaysia . 2010   42 Did not meet Critical Review Form requirements Excluded
30 Koca B, Topgul K, Yuruker SS, Cinar H, Kuru B. Non-operative treatment approach for blunt splenic injury: is grade the unique criterion? Ulus TRAVMA VE ACIL CERRAHI DERGISI-TURKISH J TRAUMA Emerg Surg. 2013 Retrospective study 31 Factors to consider NOM Included
31 Koo T-Y, Ra Y-M, Lee SE, et al. Extension of Nonoperative Management on Spleen Injury with Judicious Selection and Embolization; 10 Years of Experience. J KOREAN Surg Soc . 2011 Retrospective study 151 Lack of statistical analysis, did not meet Critical Review Form requirements Excluded
32 Kourabi M, Reibel N, Perez M, Grosdidier G. A serious late complication of non-operative management of splenic trauma: rupture of splenic artery aneurysm. J Chir (Paris) . 2008 Three case reports 3 Case reports Excluded
33 L.A. O, D. S, C.M. D, et al. Implications of the “contrast blush” finding on computed tomographic scan of the spleen in trauma. J Trauma - Inj Infect Crit Care. 2001 Retrospective study 324 Contrast blush alone should not mandate management Included
34 Le Moine M-C, Aguilar E, Vacher C, et al. Splenic injury: Management in the Languedoc-Roussillon region. Survey of public hospital surgeons. J Chir Viscerale . 2010 Survey / Surveys are not considered Excluded
35 Liu PP, Lee WC, Cheng YF, et al. Use of splenic artery embolization as an adjunct to nonsurgical management of blunt splenic injury. J Trauma . 2004 Retrospective? 39 Did not meet Critical Review Form requirements Excluded
36 Lutz N, Mahboubi S, Nance ML, Stafford PW. The significance of contrast blush on computed tomography in children with splenic injuries. J Pediatr Surg . 2004 Retrospective study 133 Paediatric population, blush does not mandate SAE Excluded
37 Marmery H, Shanmuganathan K, Alexander MT, Mirvis SE. Optimization of selection for nonoperative management of blunt splenic injury: Comparison of MDCT grading systems. Am J Roentgenol. 2007 Retrospective observational study 496 Comparison of grading systems Included
38 Marmorale C, Guercioni G, Siquini W, et al. Non-operative management of blunt abdominal injuries. Chir Ital. 2007 Retrospective study 123 Nonspecific patient group, low statistical power Excluded
39 Matsushima K, Kulaylat AN, Won EJ, Stokes AL, Schaefer EW, Frankel HL. Variation in the management of adolescent patients with blunt abdominal solid organ injury between adult versus pediatric trauma centers: an analysis of a statewide trauma database. J Surg Res . 2013 Retrospective study 1532 Paediatric study group Excluded
40 Mayglothling JA, Haan JM, Scalea TM, J.A. M, J.M. H, T.M. S. Blunt splenic injuries in the adolescent trauma population: The role of angiography and embolization. J Emerg Med . 2009 Retrospective study 97 Adolescent study group Excluded
41 Mikocka-Walus A, Beevor HC, Gabbe B, Gruen RL, Winnett J, Cameron P. Management of spleen injuries: the current profile. ANZ J Surg . 2010 Retrospective study 318 Unrepresentative patient population Excluded
42 Miller PR, Chang MC, Hoth JJ, et al. Prospective Trial of Angiography and Embolization for All Grade III to V Blunt Splenic Injuries: Nonoperative Management Success Rate Is Significantly Improved. J Am Coll Surg. 2014 Prospective study 168 Prospective use of angiography and SAE Included
43 Olthof DCC, Sierink JCC, van Delden OMM, Luitse JSKSK, Goslings JCC. Time to intervention in patients with splenic injury in a Dutch level 1 trauma centre. Inj J CARE Inj. 2014 Retrospective study 96 Time to intervention Included
44 Olthof DC, Joosse P, Bossuyt PMM, et al. Observation Versus Embolization in Patients with Blunt Splenic Injury After Trauma: A Propensity Score Analysis. World J Surg. December 2015 Propensity score analysis 206 Use of propensity score to contemperous patient groups Included
45 Olthof DC, van der Vlies CHCH, van der Vlies CHCH, et al. Consensus strategies for the nonoperative management of patients with blunt splenic injury: A Delphi study. J Trauma Acute Care Surg. 2013 Delphi study between 30 experts N/A   Included
46 P. R, T. G, B. S, et al. Management of blunt injuries to the spleen. Br J Surg. 2010 Retrospective study 206 Succes of NOM, age Included
47 Parihar ML, Kumar A, Gamanagatti S, et al. Role of splenic artery embolization in management of traumatic splenic injuries: a prospective study. Indian J Surg. 2013 Prospective study 67 Prospective study of success rates with NOM Included
48 Ransom KJ, Kavic MS. Laparoscopic splenectomy for blunt trauma: a safe operation following embolization. Surg Endosc OTHER Interv Tech . 2009 Retrospective study 46 Laparoscopic splenectomy is safe, not considered for this review Excluded
49 Requarth JA. Distal Splenic Artery Hemodynamic Changes During Transient Proximal Splenic Artery Occlusion in Blunt Splenic Injury Patients: A Mechanism of Delayed Splenic Hemorrhage. J Trauma Inj Infect Crit Care . 2010 Retrospective study 7 Distal versus proximal embolization, lack of statistical power Excluded
50 S.-C. W, R.-J. C, A.D. Y, et al. Complications associated with embolization in the treatment of blunt splenic injury. World J Surg. 2008 Retrospective study 152 Complications of SAE Included
51 Sabe AA, Claridge JA, Rosenblum DI, Lie K, Malangoni MA. The effects of splenic artery embolization on nonoperative management of blunt splenic injury: a 16-year experience. J Trauma. 2009 Retrospective study 815 Three groups, more success NOM when combined with SAE Included
52 Shih H-C, Wang C-Y, Wen Y-S, et al. Spleen artery embolization aggravates endotoxin hyporesponse of peripheral blood mononuclear cells in patients with spleen injury. J Trauma. 2010 Observational study 16 Effect of SAE on splenic function Included
53 Shiping L, Jianyong L, Zhi Z, Yun Z. Management of Traumatic Splenic Rupture in Adults: A Single Center’s Experience in Mainland China. Hepatogastroenterology . 2014 Retrospective study 125 No full text available Excluded
54 Skattum J, Loekke RJV, Titze TL, et al. Preserved function after angioembolisation of splenic injury in children and adolescents: A case control study. Inj J CARE Inj . 2014 Case control 11 Pediatric and adolescent study group, case control Excluded
55 Soo K-M, Lin T-Y, Chen C-W, et al. More Becomes Less: Management Strategy Has Definitely Changed over the Past Decade of Splenic Injury-A Nationwide Population-Based Study. Biomed Res Int . 2015 Retrospective study 578 Lack of statistical analysis, no added value to article Excluded
56 Stassen NA, Bhullar I, Cheng JD, et al. Selective nonoperative management of blunt splenic injury: An Eastern Association for the Surgery of Trauma practice management guideline. J Trauma Acute Care Surg . 2012 Guideline N/A Guideline Excluded
57 Wahl WL, Ahrns KS, Chen S, et al. Blunt splenic injury: Operation versus angiographic embolization. Surgery. 2004 Retrospective study 164 Factors to consider for indication of SAE versus operative management Included
58 Wei B, Hemmila MR, Arbabi S, et al. Angioembolization reduces operative intervention for blunt splenic injury. J Trauma - Inj Infect Crit Care. 2008 Retrospective study 317 less complications and better outcomes with SAE Included
59 Wu S-C, Fu C-Y, Muo C-H, Chang Y-J. Splenectomy in trauma patients is associated with an increased risk of postoperative type II diabetes: a nationwide population-based study. Am J Surg. 2014 Retrospective study 3723 Increased risk for T2DM Included
60 Zarzaur BL, Croce MA, Fabian TC. Variation in the Use of Urgent Splenectomy After Blunt Splenic Injury in Adults. J TRAUMA-INJURY Infect Crit CARE. 2011 Retrospective study 11.793 Mortality after splenectomy Included
61 Zarzaur BL, Savage SA, Croce MA, Fabian TC. Trauma center angiography use in high-grade blunt splenic injuries: Timing is everything. J Trauma Acute Care Surg. 2014 Retrospective study 10.405 Use of angio and role in splenectomy Included
62 Zarzaur BL, Kozar R, Myers JG, et al. The splenic injury outcomes trial. J Trauma Acute Care Surg. 2015 Prospective observational study 383 Risk of splenectomy after NOM + SAE, importance of blush on CT Included