title: Factors that influence the operative mortality after blunt hepatic injuries.
abstract: OBJECTIVE
  To analyse causes of death and possible factors that influenced the operative mortality in patients with blunt hepatic injuries.
  
  
  METHODS
  Retrospective case study.
  
  
  METHODS
  Medical center, Taiwan.
  
  
  METHODS
  109 adult patients with blunt hepatic injuries were treated surgically over the four year period from September 1987 to August 1991.
  
  
  METHODS
  Mortality.
  
  
  RESULTS
  36 patients (33%) had hepatorrhaphy or no repair, complex repairs were done for 73 patients (67%) and the overall mortality was 22% (24/109). Of those deaths, however, 4 were not liver-related, giving us a liver-related mortality of 19% (20/105). Fourteen of the liver-related deaths occurred within 24 hours of injury of hemorrhagic shock or coagulopathy. Six occurred after 24 hours of sepsis and multiple system organ failure. Multivariate analysis showed that higher initial aspartate aminotransferase (AST) and Injury Severity Score as well as increasing operative blood loss resulted in a worsening prognosis.
  
  
  CONCLUSIONS
  The initial AST activity and Injury Severity Score as well as the total operative blood loss were the significant factors that influenced the operative mortality after blunt hepatic injuries in our study. Prompt, expeditious, and appropriate surgical management to control operative loss is the only way for the surgeon to reduce the mortality of blunt hepatic injuries.
authors: Division of Trauma and Emergency Surgery, Chang Gung Medical College, Chang Gung Memorial Hospital Taipei, Taiwan, ROC.
authors: R J
authors: RJ
authors: Chen
authors: J F
authors: JF
authors: Fang
authors: B C
authors: BC
authors: Lin
authors: Y D
authors: YD
authors: Wang
authors: M F
authors: MF
authors: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001219:Aspartate Aminotransferases / Q000097:blood; D002423:Cause of Death; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008099:Liver / Q000293:injuries* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014949:Wounds, Nonpenetrating / Q000401:mortality* / Q000601:surgery
chemical_list: D001219:Aspartate Aminotransferases