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Improvement of mortality in severe liver injury after trauma center implementation: a propensity score matched study



To evaluate changes in the management and outcome of severe liver injury after trauma center implementation.


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.


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.


Severe liver injury management improved after trauma center implementation.

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Correspondence to Byung Hee Kang.

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All authors have no conflict of interest

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The study was reviewed and approved by the Institutional Review Board of our institution (AJIRB-MED-21-384).

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Because of retrospective nature of this study, informed consent was waived by our Institutional Review Board.

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Choi, D., Kwon, J., Jung, K. et al. Improvement of mortality in severe liver injury after trauma center implementation: a propensity score matched study. Eur J Trauma Emerg Surg 48, 3349–3355 (2022).

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  • Liver
  • Wounds and injuries
  • Trauma center
  • Therapeutics
  • Treatment outcome