Trends in the management of hepatic injury. Am J Surg 1997 Dec;174(6):674-7
Date
12/31/1997Pubmed ID
9409595DOI
10.1016/s0002-9610(97)00209-2Scopus ID
2-s2.0-0031440824 (requires institutional sign-in at Scopus site) 55 CitationsAbstract
BACKGROUND: Options for management of blunt hepatic injury have broadened to include both operative management (OM) and nonoperative management (NOM). We identify trends in evaluation and management of blunt hepatic injury at a level 1 trauma center.
METHODS: Charts of 106 patients with blunt hepatic injuries from July 1, 1991 to June 30, 1995 were reviewed for method of abdominal evaluation (computed tomography versus DPL), injury severity score, liver injury grade, method of management, length of stay (LOS), transfusion requirements, complications, and outcome.
RESULTS: Nonoperative management steadily increased to 86%. Successful NOM occurred in 96% (48 of 50) and was not related to injury grade. Transfusion requirements were significantly greater in the group with OM versus those with NOM (11.3 versus 2.7). Patients with NOM also had significantly shorter intensive care unit stay and total LOS.
CONCLUSIONS: The majority of patients with blunt liver injury can be successfully managed nonoperatively regardless of injury grade. Nonoperative management may allow decreased resource utilization because of shorter hospital stays and decreased transfusion requirements.
Author List
Brasel KJ, DeLisle CM, Olson CJ, Borgstrom DCMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Aged
Aged, 80 and over
Blood Transfusion
Child
Child, Preschool
Humans
Length of Stay
Liver
Middle Aged
Wounds, Nonpenetrating
