Document Detail


Evolution in the management of the complex liver injury at a Level I trauma center.
MedLine Citation:
PMID:  9680016     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Management of the severe liver injury evolved from mandatory surgical repair to a more selective approach. This paper reviews the changes in management of the severe liver injury at a Level I trauma center. METHODS: We reviewed the records of patients with severe liver injury admitted to a Level I trauma center between January 1984 and December 1995. The patients were divided into two groups, G1 and G2, based on their date of admission before or after January 1991. The two groups were compared for blood products use, management of the liver injury, and outcome. RESULTS: One hundred six patients were compared for age, sex, Acute Physiology and Chronic Health Evaluation II score, Injury Severity Score, abdominal Abbreviated Injury Scale score, and the presence of concomitant injuries. There was no difference in management or outcome of the victims of penetrating injury between G1 and G2 (n = 48). The blunt injury patients in G1 (n = 22) had more liver surgery (p = 0.006), blood transfusion (p = 0.040), intra-abdominal sepsis (6 vs. 0), and higher mortality (p = 0.041) than those in G2 (n = 36). CONCLUSION: Isolated severe blunt liver injury may be managed nonoperatively with better survival and less blood products use.
Authors:
R Cachecho; D Clas; K Gersin; G A Grindlinger
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of trauma     Volume:  45     ISSN:  0022-5282     ISO Abbreviation:  J Trauma     Publication Date:  1998 Jul 
Date Detail:
Created Date:  1998-08-12     Completed Date:  1998-08-12     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0376373     Medline TA:  J Trauma     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  79-82     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, Boston Medical Center, Massachusetts 02218-2393, USA. riad.cachecho@bmc.org
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MeSH Terms
Descriptor/Qualifier:
APACHE
Adolescent
Adult
Aged
Aged, 80 and over
Boston
Child
Clinical Protocols
Female
Humans
Liver / injuries*
Male
Middle Aged
Multiple Trauma / therapy*
Retrospective Studies
Trauma Centers / standards
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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