Original scientific articleImpact of Cirrhosis on Outcomes in Trauma
Section snippets
Methods
This study protocol was carried out with the approval of our institutional review board. A review of registry data for all trauma patients admitted from January 1, 1999, through December 31, 2003, was performed. Patients were divided into those with preinjury liver disease, ie, International Classification of Diseases, 9th revision, (ICD-9) codes 571.2 and 571.5, and those without liver disease. The two groups were further characterized with respect to age, mechanism of injury, ISS, anatomic
Results
Fifty patients meeting study criteria for preexisting liver disease were identified during the outlined period. Thirty-one patients (62%) had cirrhosis related to alcohol use, 18 (36%) had cirrhosis related to history of hepatitis C, and 1 patient (2%) had cryptogenic cirrhosis. There were 20 (40%) patients meeting CTP class A criteria, 16 (32%) meeting CTP class B criteria, and 14 (28%) with CTP class C cirrhosis (Table 1). There were no statistically significant differences in age, TRISS,
Discussion
To date, this is the largest series reported in the literature focusing on trauma patients with preexisting cirrhosis. The mortality rate for CTP class C cirrhotic patients posttrauma continues to be higher than that predicted by TRISS. But patients with less severe hepatic dysfunction do not appear to have significantly lower than predicted survival. To the best of our knowledge, this is the first study to demonstrate that mortality posttrauma correlates independently with the degree of
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Competing Interests Declared: None.