Factors affecting outcomes in traumatic liver injury: A retrospective study

Aim To achieve better outcomes, nonoperative management (NOM) and damage control surgery (DCS) are now recommended for traumatic liver injury. The aim of the present study was to review the outcomes of patients suffering from liver trauma and to determine the factors affecting the outcomes, with emp...

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Bibliographic Details
Published in:	Surgical practice Vol. 21; no. 2; pp. 63 - 69
Main Authors:	Lee, Kit‐Fai, Chong, Charing Ching‐Ning, Yeung, Janice Hiu‐Hung, Cheung, Nai‐Kwong, Siu, Eva Yin‐Yu, Cheung, Yue‐Sun, Wong, John, Lai, Paul Bo‐San
Format:	Journal Article
Language:	English
Published:	Melbourne Wiley Publishing Asia Pty Ltd 01-05-2017 Blackwell Publishing Ltd
Subjects:	damage control surgery hepatectomy liver injury nonoperative management
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Summary:	Aim To achieve better outcomes, nonoperative management (NOM) and damage control surgery (DCS) are now recommended for traumatic liver injury. The aim of the present study was to review the outcomes of patients suffering from liver trauma and to determine the factors affecting the outcomes, with emphasis on NOM and DCS. Patients and Methods This was a retrospective cohort study for liver trauma patients from a single centre. The outcomes were compared between two equal consecutive periods: period A (2001–2007) and period B (2008–2014). Results There were 116 patients, with a mean age of 38.1 years and a male predominance (61.2 per cent). Approximately 57 per cent of patients suffered from grade III or higher liver injury. The mean Injury Severity Score (ISS) was 32.3. The 90‐day mortality was 20.7 per cent. During period B, the 90‐day mortality was significantly lowered (6/56 vs 18/60, P = 0.010) with less liver operations (13/56 vs 26/60, P = 0.022) and more hepatic angiography ± embolization (7/56 vs 0/60, P = 0.005). The proportion of DCS was similar, but more hepatectomies were performed in period B (4/13 vs 0/26, P = 0.009). Multivariate analysis revealed that ISS grade, age and sex were predictors for 90‐day mortality. Conclusions Reduced mortality was seen in traumatic liver injury accomplished by increased NOM, but not DCS.
ISSN:	1744-1625 1744-1633
DOI:	10.1111/1744-1633.12237