Patterns of traumatic liver injury and mortality: A five-year study at shahid rajaei hospital (2018–2023)

Surgery Open Digestive Advance Pub Date : 2025-05-26 DOI:10.1016/j.soda.2025.100211

M. Yadollahi , S. Hamedani

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引用次数: 0

Abstract

Background

The liver is the most commonly afflicted organ in abdominal trauma, manageable conservatively or operatively. However, debate persists over case selection for operative management. We aimed to evaluate our experience with liver trauma management and provide insights for improved case management.

Methods and Materials

In this retrospective cross-sectional study, all patients with traumatic liver injury over a five-year period were evaluated. Imaging studies were reassessed by radiologists to calculate the Injury Severity Score (ISS). Treatment trends and comparisons between operatively and non-operatively managed patients were analyzed.

Results

A total of 209 patients (mean age 34.72 ± 16.1 years, 79.4 % male) included 45.9 % (n = 96) managed non-operatively and 54.1 % (n = 113) operatively, with 23.9 % (n = 50) mortality. AAST Grade V injuries occurred in 1.9 % (n = 4); 48.3 % (n = 101) had ISS ≥25. AAST predicted operative need (P = 0.037) but not mortality (P = 0.217); ISS predicted mortality (P = 0.041) but not operative management (P = 0.432). Operative predictors included penetrating trauma (aOR=5.12, P = 0.011), transfusion (aOR=1.58, P < 0.001), volume resuscitation (aOR=1.89, P < 0.001), catecholamine use (aOR=2.97, P = 0.017), and AAST IV/V (aOR=4.25, P = 0.006). Mortality correlated with age, lower Glasgow Coma Scale (GCS), and transfusion needs.

Conclusion

ISS excels in mortality prediction, while AAST and resuscitation markers guide operative decisions. Integrating these enhances trauma care precision.

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外伤性肝损伤模式和死亡率：shahid rajaei医院的五年研究（2018-2023）

背景：肝脏是腹部创伤中最常见的受累器官，可采用保守或手术治疗。然而，关于手术治疗病例选择的争论仍然存在。我们的目的是评估我们在肝外伤管理方面的经验，并为改进病例管理提供见解。方法和材料在这项回顾性横断面研究中，对所有5年内的外伤性肝损伤患者进行了评估。影像学检查由放射科医生重新评估，以计算损伤严重程度评分（ISS）。分析了手术和非手术治疗患者的治疗趋势和比较。结果209例患者（平均年龄34.72±16.1岁，男性79.4%），其中非手术治疗占45.9% (n = 96)，手术治疗占54.1% (n = 113)，病死率23.9% （n = 50）。AAST V级损伤发生率为1.9% (n = 4)；48.3% （n = 101）的ISS≥25。AAST预测手术需求（P = 0.037），但不能预测死亡率（P = 0.217）；ISS预测死亡率（P = 0.041），但不能预测手术管理（P = 0.432）。手术预测因素包括穿透性创伤（aOR=5.12, P = 0.011）、输血(aOR=1.58, P <；0.001)，容积复苏(aOR=1.89, P <；0.001)、儿茶酚胺使用（aOR=2.97, P = 0.017）和AAST IV/V （aOR=4.25, P = 0.006）。死亡率与年龄、较低的格拉斯哥昏迷评分（GCS）和输血需求相关。结论iss在预测死亡率方面具有优势，而AAST和复苏指标可指导手术决策。整合这些可以提高创伤护理的准确性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Surgery Open Digestive Advance

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