PURPOSE: The liver is one of the most commonly injured organs in abdominal trauma. Surgery has played a major role in treating traumatic liver injury. Recently, it was reported that conservative treatment could be the first-line management for the
hemodynamically stable patients without combined intraabdominal surgical problems. However, the risk of mortality remains high in this type of injury. The aim of this study was to examine the prognostic factors in traumatic liver injury. METHODS: The
medical records of 132 patients who were treated for traumatic liver injury at Ewha Womans University, Mokdong Hospital from March 1994 to June 2001 were reviewed. The initial systolic blood pressure, prehospital transportation time, the number of
associated organ injury, the level of initial hemoglobin, the grade of liver injury, the treatment method, the preoperative preparation time, the amount of estimated intraoperative blood loss, and the amount of intraoperative transfusion were analyzed
with a univariate analysis and a multivariate analysis. RESULTS: Among the 132 patients, 76 cases (57.6%) were managed non-surgically, and 56 cases (42.4%) underwent surgery. Out of the 17 cases (12.9%) of mortality, 14 (82.4%) were encountered in those
who underwent surgery and 3 cases (17.6%) were encountered in those who were treated nonsurgically. Univariate analysis revealed that the initial systolic blood pressure, prehospital transportation time, initial hemoglobin level, the number of
associated organ injury, the surgical treatment, the grade of liver injury and the amount of intraoperative transfusion were significant prognostic factors for the survival. Multivariate analysis indicated that the initial systolic blood pressure and
the extent of associated organ injury were the independent prognostic factors. CONCLUSION: The patients with unstable vital signs initially and multiple associated organ injuries have a poor prognosis. Aggressive management might be helpful for
improving the survival rate in these patients.
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