Is the Grading of Liver Injuries a Useful Clinical Tool in the Initial Management of Blunt Trauma Patients?

European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society
Thomas S HellingJennifer Balon

Abstract

Computed tomography (CT) has become the preferred method for evaluation of the abdomen for victims of blunt trauma. Grading of liver injuries, primarily by CT, has been advocated as a measure of severity and, by implication, the likelihood for intervention or complications. We have sought to determine if grading of liver injuries, as a clinical tool, affects immediate or extended management of patients. We have retrospectively reviewed all patients sustaining blunt liver injuries as diagnosed by CT over a five-year period at a Level I trauma center to determine if grading of injury influenced management. The AAST organ scaling system was utilized (major grade 4-5, minor grade 1-3), as well as the ISS, AIS, mortality, morbidity, and treatment. There were 133 patients available for review. The patients were grouped into major (n = 20) and minor (n = 113) liver injuries and operative (n = 12) and nonoperative (n = 121) management. Major liver injuries had a higher ISS (39 + 13 vs. 27 + 15, p = 0.001) and were more likely to require operative intervention (5/20 vs. 7/113, p = 0.02). Mortality in this group was not different (major vs. minor), and there were no differences in the incidence of complications. Twelve patients (9%) requ...Continue Reading

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Citations

Feb 3, 2011·Emergency Radiology·Arash EftekhariSavvas Nicolaou
Aug 14, 2013·The Journal of Sexual Medicine·Michael D Berry, Philip D Berry
Jul 7, 2012·Food Additives & Contaminants. Part A, Chemistry, Analysis, Control, Exposure & Risk Assessment·R HellingT J Simat
May 16, 2014·Acta Anaesthesiologica Scandinavica·K GjeraaD Østergaard
Jan 20, 2017·The Indian Journal of Surgery·Abdel Fattah SalehAmr Elheny

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