Anzeige
Erschienen in:
14.02.2022 | Original Article
Improvement of mortality in severe liver injury after trauma center implementation: a propensity score matched study
Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 4/2022
Einloggen, um Zugang zu erhaltenAbstract
Purpose
To evaluate changes in the management and outcome of severe liver injury after trauma center implementation.
Methods
Trauma patients with severe liver injury (organ injury scale score ≥ 4) treated between January 2011 and December 2020 were retrospectively reviewed. A trauma center was built in 2016 at our institution, and patients were dichotomized into two groups: before trauma center (BTC) and after trauma center (ATC) group. Treatment methods and outcomes were compared between the groups with 1:1 propensity score matching.
Results
We included 50 patients in the BTC group and 104 patients in the ATC group. Patients in the ATC group had frequent utilization of angiography (16% vs 47.1%, p < 0.001), faster transfusion [84 (37–152) min vs 17 (10–79) min, p < 0.001], and less fluid administration within 24 h [8.3 (5.7–13.7) L vs 5.7 (3.1–10.1) L, p = 0.002]. However, mortality rate was not significantly different between the groups (26.0% vs 20.2%, p = 0.416). 1:1 propensity score matching was performed using the variables of age, injury severity score, systolic blood pressure, Glasgow Coma Scale, and initial base excess level. After matching, the mortality rate (26.0% vs 10.0%, p = 0.037) and ventilator application (74.0% vs 54.0%, p = 0.037) significantly improved.
Conclusion
Severe liver injury management improved after trauma center implementation.