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The negative effect of preexisting cirrhosis on blunt liver trauma patients: a multifaceted approach from the trauma quality improvement program database.
Hsu, Ting-An; Kang, Shih-Ching; Tee, Yu-San; Bokhari, Faran; Fu, Chih-Yuan.
Afiliación
  • Hsu TA; Department of Trauma and Emergency Surgery, Linkou Chang Gung Memorial Hospital, Chang Gung University, 5, Fu-Hsing Street, Kwei Shan Township, Taoyuan, Taiwan.
  • Kang SC; Department of Trauma and Emergency Surgery, Linkou Chang Gung Memorial Hospital, Chang Gung University, 5, Fu-Hsing Street, Kwei Shan Township, Taoyuan, Taiwan.
  • Tee YS; Department of Trauma and Emergency Surgery, Linkou Chang Gung Memorial Hospital, Chang Gung University, 5, Fu-Hsing Street, Kwei Shan Township, Taoyuan, Taiwan.
  • Bokhari F; Emergency Surgical Services, St. Francis Hospital, OSF Healthcare System, Peoria, IL, USA.
  • Fu CY; Department of Trauma and Emergency Surgery, Linkou Chang Gung Memorial Hospital, Chang Gung University, 5, Fu-Hsing Street, Kwei Shan Township, Taoyuan, Taiwan. drfu5564@gmail.com.
Eur J Trauma Emerg Surg ; 2024 Sep 03.
Article en En | MEDLINE | ID: mdl-39251436
ABSTRACT

PURPOSE:

To assess the impact of pre-existing cirrhosis on the outcomes of non-operatively managed blunt liver trauma within the Trauma Quality Improvement Program (TQIP) database.

METHODS:

A study of non-operatively managed blunt liver injury patients from 2016 to 2019 was conducted. Propensity score matching analyzed mortality, complications, and hospital length of stay (LOS) for patients with and without cirrhosis. The effect of transcatheter arterial embolization (TAE) was determined using multivariate logistic regression.

RESULTS:

Out of 63,946 patients, 767 (1.2%) had pre-existing cirrhosis. Following 11 matching, those with cirrhosis experienced more hemorrhage (TAE need 5.7% vs. 2.7%; transfusion volume 639.1 vs. 259.3 ml), complications (acute kidney injury 5.1% vs. 2.8%; sepsis 2.4% vs. 1.0%), and poorer outcomes (mortality 19.5% vs. 10.2%; hospital LOS 11.6 vs. 8.4 days; ICU LOS 12.1 vs. 7.4 days; ventilator days 7.6 vs. 1.6). Notably, TAE was associated with increased mortality in cirrhotic patients (odds ratio 4.093) but did not significantly affect mortality in patients without cirrhosis.

CONCLUSIONS:

Within TQIP, pre-existing cirrhosis is a significant negative determinant for outcomes in blunt liver trauma. Cirrhotic patients undergoing TAE for hemostasis face greater mortality risk than non-cirrhotic counterparts.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Eur J Trauma Emerg Surg Año: 2024 Tipo del documento: Article País de afiliación: Taiwán Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: Eur J Trauma Emerg Surg Año: 2024 Tipo del documento: Article País de afiliación: Taiwán Pais de publicación: Alemania