Traumatic Liver Injury: Factors Associated with Mortality
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: We postulate that a delay in the implementation of hepatic arterial embolization for traumatic liver injury patients will negatively affect patient prognosis. Our work also seeks to identify factors related to the mortality rate among traumatic liver injury patients. Methods: From January 2008 to April 2014, patients who had been admitted to the emergency room, were subsequently diagnosed with traumatic liver injury, and later underwent hepatic arterial embolization were included in this retrospective study. Results: Of the 149 patients that underwent hepatic arterial embolization, 86 had the procedure due to traumatic liver injury. Excluding the 3 patients that were admitted to the hospital before procedure, the remaining 83 patients were used as subjects for the study. The average time between emergency room arrival and incidence of procedure was 164 min for the survival group and 132 min for the non-survival group; this was not statistically significant (p = 0.170). The average time to intervention was 182 min for the hemodynamically stable group, and 149 min for the hemodynamically unstable group, the latter having a significantly shorter wait time (p = 0.047). Of the factors related to the mortality rate, the odds ratio of the Glasgow Coma Score (GCS) was 18.48 (p < 0.001), and that of albumin level was 0.368 (p = 0.006). Conclusions: In analyzing the correlation between mortality rate and the time from patient admission to arrival for hepatic arterial embolization, there was no statistical significance observed. Of the factors related to the mortality rate, GCS and albumin level may be used as prognostic factors in traumatic liver injury.
Abstract
Background: We postulate that a delay in the implementation of hepatic arterial embolization for traumatic liver injury patients will negatively affect patient prognosis. Our work also seeks to identify factors related to the mortality rate among traumatic liver injury patients. Methods: From January 2008 to April 2014, patients who had been admitted to the emergency room, were subsequently diagnosed with traumatic liver injury, and later underwent hepatic arterial embolization were included in this retrospective study. Results: Of the 149 patients that underwent hepatic arterial embolization, 86 had the procedure due to traumatic liver injury. Excluding the 3 patients that were admitted to the hospital before procedure, the remaining 83 patients were used as subjects for the study. The average time between emergency room arrival and incidence of procedure was 164 min for the survival group and 132 min for the non-survival group; this was not statistically significant (p = 0.170). The average time to intervention was 182 min for the hemodynamically stable group, and 149 min for the hemodynamically unstable group, the latter having a significantly shorter wait time (p = 0.047). Of the factors related to the mortality rate, the odds ratio of the Glasgow Coma Score (GCS) was 18.48 (p < 0.001), and that of albumin level was 0.368 (p = 0.006). Conclusions: In analyzing the correlation between mortality rate and the time from patient admission to arrival for hepatic arterial embolization, there was no statistical significance observed. Of the factors related to the mortality rate, GCS and albumin level may be used as prognostic factors in traumatic liver injury.
참고문헌 (19)
- Søreide K, "Epidemiology of major trauma", Br J Surg, 96, pp.697~698 (2009)
- Clarke JR, "Time to laparotomy for intra-abdominal bleeding from trauma does affect survival for delays up to 90 minutes", J Trauma, 52, pp.420~425 (2002)
- Park WD, "Traumatic liver injury", Korean J Crit Care Med, 5, pp.67~74 (1990)
- Beardsley C, "An overview of liver trauma", MSJA, 3, pp.5~10 (2011)
- Cha SH, "Use of a postoperative hepatic arterial embolization in patients with postoperative bleeding due to severe hepatic injuries", J Korean Soc Traumatol, 19, pp.59~66 (2006)
- Chien LC, "Incidence of liver trauma and relative risk factors for mortality: a population-based study", J Chin Med Assoc, 76, pp.576~582 (2013)
- Kim SC, "The validity of hepatic arterial embolization in management of traumatic liver injury", J Korean Soc Traumatol, 17, pp.131~138 (2004)
- Malhotra AK, "Blunt hepatic injury: a paradigm shift from operative to nonoperative management in the 1990s", Ann Surg, 231, pp.804~813 (2000)
- Yoon HM, "Clinical analysis on patients with traumatic liver injury", J Korean Soc Traumatol, 20, pp.125~129 (2007)
- Olthof DC, "Time to intervention in patients with splenic injury in a Dutch level 1 trauma centre", Injury, 45, pp.95~100 (2014)
- Cogbill TH, "Severe hepatic trauma: a multi-center experience with 1,335 liver injuries", J Trauma, 28, pp.1433~1438 (1988)
- Feliciano DV, "Management of 1000 consecutive cases of hepatic trauma (1979-1984)", Ann Surg, 204, pp.438~445 (1986)
- Holden A, "Abdomen--interventions for solid organ injury", Injury, 39, pp.1275~1289 (2008)
- Demetriades D, "Mortality prediction of head abbreviated injury score and glasgow coma scale: analysis of 7,764 head injuries", J Am Coll Surg, 199, pp.216~222 (2004)
- Sternbach GL, "The Glasgow coma scale", J Emerg Med, 19, pp.67~71 (2000)
- Fearnside MR, "The Westmead head injury project outcome in severe head injury. A comparative analysis of pre-hospital, clinical and CT variables", Br J Neurosurg, 7, pp.267~279 (1993)
- Lee WC, "Combination of white blood cell count with liver enzymes in the diagnosis of blunt liver laceration", Am J Emerg Med, 28, pp.1024~1029 (2010)
- Howell GM, "Delay to therapeutic interventional radiology postinjury: time is of the essence", J Trauma, 68, pp.1296~1300 (2010)
- Bernardo CG, "Treatment of liver trauma: operative or conservative management", Gastroenterology Research, 3, pp.9~18 (2010)
