title: Outcome analysis of management of liver trauma: A 10-year experience at a trauma center.
abstract: OBJECTIVE
  To review the outcomes of liver trauma in patients with hepatic injuries only and in patients with associated injuries outside the liver.
  
  
  METHODS
  Data of liver trauma patients presented to our center from January 2003 to October 2013 were reviewed. The patients were divided into two groups. Group 1 consisted of patients who had hepatic injuries only. Group 2 consisted of patients who also had associated injuries outside the liver.
  
  
  RESULTS
  Seven (30.4%) patients in group 1 and 10 (28.6%) patients in group 2 received non-operative management; the rest underwent operation. Blunt trauma occurred in 82.8% (48/58) of the patients and penetrative trauma in 17.2% (10/58). A higher injury severity score (ISS) was observed in group 2 (median 45 vs 25, P < 0.0001). More patients in group 1 were hemodynamically stable (65.2% vs 37.1%, P = 0.036). Other parameters were comparable between groups. Group 1 had better 30-d survival (91.3% vs 71.4%, P = 0.045). On multivariate analysis using the logistic regression model, ISS was found to be associated with mortality (P = 0.004, hazard ratio = 1.035, 95%CI: 1.011-1.060).
  
  
  CONCLUSIONS
  Liver trauma patients with multiple injuries are relatively unstable on presentation. Despite a higher ISS in group 2, non-operative management was possible for selected patients. Associated injuries outside the liver usually account for morbidity and mortality.
authors.affiliation: Wong Hoi She, Tan To Cheung, Wing Chiu Dai, Simon H Y Tsang, Albert C Y Chan, Daniel K H Tong, Gilberto K K Leung, Chung Mau Lo, Department of Surgery, Queen Mary Hospital, the University of Hong Kong, Hong Kong, China.
authors.forename: Wong Hoi
authors.initials: WH
authors.lastname: She
authors.affiliation: Wong Hoi She, Tan To Cheung, Wing Chiu Dai, Simon H Y Tsang, Albert C Y Chan, Daniel K H Tong, Gilberto K K Leung, Chung Mau Lo, Department of Surgery, Queen Mary Hospital, the University of Hong Kong, Hong Kong, China.
authors.forename: Tan To
authors.initials: TT
authors.lastname: Cheung
authors.affiliation: Wong Hoi She, Tan To Cheung, Wing Chiu Dai, Simon H Y Tsang, Albert C Y Chan, Daniel K H Tong, Gilberto K K Leung, Chung Mau Lo, Department of Surgery, Queen Mary Hospital, the University of Hong Kong, Hong Kong, China.
authors.forename: Wing Chiu
authors.initials: WC
authors.lastname: Dai
authors.affiliation: Wong Hoi She, Tan To Cheung, Wing Chiu Dai, Simon H Y Tsang, Albert C Y Chan, Daniel K H Tong, Gilberto K K Leung, Chung Mau Lo, Department of Surgery, Queen Mary Hospital, the University of Hong Kong, Hong Kong, China.
authors.forename: Simon H Y
authors.initials: SH
authors.lastname: Tsang
authors.affiliation: Wong Hoi She, Tan To Cheung, Wing Chiu Dai, Simon H Y Tsang, Albert C Y Chan, Daniel K H Tong, Gilberto K K Leung, Chung Mau Lo, Department of Surgery, Queen Mary Hospital, the University of Hong Kong, Hong Kong, China.
authors.forename: Albert C Y
authors.initials: AC
authors.lastname: Chan
authors.affiliation: Wong Hoi She, Tan To Cheung, Wing Chiu Dai, Simon H Y Tsang, Albert C Y Chan, Daniel K H Tong, Gilberto K K Leung, Chung Mau Lo, Department of Surgery, Queen Mary Hospital, the University of Hong Kong, Hong Kong, China.
authors.forename: Daniel K H
authors.initials: DK
authors.lastname: Tong
authors.affiliation: Wong Hoi She, Tan To Cheung, Wing Chiu Dai, Simon H Y Tsang, Albert C Y Chan, Daniel K H Tong, Gilberto K K Leung, Chung Mau Lo, Department of Surgery, Queen Mary Hospital, the University of Hong Kong, Hong Kong, China.
authors.forename: Gilberto K K
authors.initials: GK
authors.lastname: Leung
authors.affiliation: Wong Hoi She, Tan To Cheung, Wing Chiu Dai, Simon H Y Tsang, Albert C Y Chan, Daniel K H Tong, Gilberto K K Leung, Chung Mau Lo, Department of Surgery, Queen Mary Hospital, the University of Hong Kong, Hong Kong, China.
authors.forename: Chung Mau
authors.initials: CM
authors.lastname: Lo
keywords: Blunt trauma; Liver laceration; Liver trauma; Multiple injuries; Non-operative management; Penetrative trauma