title: Elevated liver enzymes following polytraumatic injury.
abstract: This retrospective cohort study examined the prevalence and potential risk factors for elevated liver enzymes in patients following traumatic brain injury (TBI). The participants were servicemembers with TBI admitted to the Polytrauma Rehabilitation Center (PRC) at the Hunter Holmes McGuire Department of Veterans Affairs Medical Center in Richmond, Virginia, from January 2008 through December 2011. The PRC had 207 patients during this time period, 121 of whom had a liver panel within 30 d of injury. Patients were retrospectively analyzed and placed into one of two categories based on alanine aminotransferase (ALT) values. Of the 121 subjects, 59 (49%) had an ALT of 44 IU/L or greater on their initial set of laboratories. These subjects were compared with those with an ALT of 43 IU/L or less using chi square analysis. There were no significant differences between the two groups with regards to sex, military status, race, theater, TBI mechanism, severity of TBI, or concomitant injuries. Regardless of demographics, mechanism of injury, or extent of trauma, elevated liver enzymes are common in patients admitted to the rehabilitation unit following TBI. For the majority of these patients, enzymes returned to normal with conservative management. In most cases, no specific etiology was ever defined. Further analysis will be performed to determine the most efficient way to monitor these patients so that unnecessary test are avoided and medical expenses are minimized.
authors.forename: Aaron
authors.initials: A
authors.lastname: Fox
authors.forename: James B
authors.initials: JB
authors.lastname: Sanderlin
authors.forename: Shane
authors.initials: S
authors.lastname: McNamee
authors.forename: Jasmohan S
authors.initials: JS
authors.lastname: Bajaj
authors.forename: William
authors.initials: W
authors.lastname: Carne
authors.forename: David X
authors.initials: DX
authors.lastname: Cifu
mesh_terms: D000410:Alanine Transaminase / Q000097:blood*; D001930:Brain Injuries / Q000175:diagnosis / Q000201:enzymology / Q000534:rehabilitation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008099:Liver; D008111:Liver Function Tests; D008297:Male; D008889:Military Personnel; D008991:Monitoring, Physiologic; D009104:Multiple Trauma / Q000175:diagnosis / Q000201:enzymology* / Q000534:rehabilitation; D012189:Retrospective Studies; D013997:Time Factors; D015599:Trauma Severity Indices
chemical_list: D000410:Alanine Transaminase
keywords: TBI; Veteran; blast injuries; brain injury; drug-induced liver injuries; liver enzyme elevations; liver function tests; polytraumatic injury; rehabilitation; trauma severity indices