title: Comparison of isolated and concomitant liver injuries: is hepatic trauma entirely responsible for the outcome?
abstract: OBJECTIVE
  This study was undertaken to examine both isolated and concomitant liver injuries to clarify the role of liver trauma on outcome.
  
  
  METHODS
  This retrospective study was a review of all abdominal trauma patients who presented with liver injuries, with or without concomitant injury at Ege University School of Medicine over a 3-year period. Presentation, injury grade, management, and outcomes were analyzed. Patients with isolated hepatic injury (Group A) were compared with patients who had concomitant hepatic injury (liver and spleen/small bowel) (Group B). Significance was set at 95% confidence intervals.
  
  
  RESULTS
  Of 368 patients, 80 (21%) presented with liver injury. Of these, the aetiology was as follows: 53 (66.2%) blunt injury, 19 (23%) penetrating injury, and 8 (10%) gun shot trauma. There were 38 patients in Group A and 42 in Group B. Of these 42 patients, 19 were diagnosed with serious types of injury ; eight thoracic, three open long bone fracture, one intra-cardiac, one intracranial. Six additional patients were observed with injuries to large abdominal vessels. Eleven patients (28.9%) with isolated hepatic injury were managed non-operatively. Mortality, intensive care unit and hospital length of stay, and transfusion requirements were significantly higher in Group B. Only the number of transfused blood units and the grade of liver injury were found to be effective on outcome whereas stepwise regression analysis revealed that injury type (penetrating) and blood transfusion were predictive for mortality.
  
  
  CONCLUSIONS
  This study highlighted that although isolated liver injury results in good outcome with non-operative management, concomitant injuries to the liver lead to a higher failure and mortality rate. However, liver injury itself is rarely responsible for death.
authors.affiliation: Department of General Surgery, Ege University School of Medicine, Izmir, Turkey. pinar.yazici@ege.edu.tr
authors.forename: P
authors.initials: P
authors.lastname: Yazici
authors.forename: U
authors.initials: U
authors.lastname: Aydin
authors.forename: M
authors.initials: M
authors.lastname: Sozbilen
mesh_terms: D000007:Abdominal Injuries / Q000401:mortality* / Q000628:therapy; D000293:Adolescent; D000328:Adult; D000368:Aged; D001803:Blood Transfusion; D005260:Female; D006801:Humans; D022125:Lacerations / Q000401:mortality; D007902:Length of Stay; D008099:Liver / Q000293:injuries*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000401:mortality* / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D014949:Wounds, Nonpenetrating / Q000401:mortality; D014950:Wounds, Penetrating / Q000401:mortality; D055815:Young Adult