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

European Journal of Trauma and Emergency Surgery volume 48, pages 3349–3355 (2022)Cite this article

Abstract

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.

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Authors and Affiliations

  1. Division of Trauma Surgery, Department of Surgery, Ajou University School of Medicine, 164 Worldcup-ro, Yeongtong-gu, Suwon-si, Gyeonggi-do, 16499, Republic of Korea

    Donghwan Choi, Junsik Kwon, Kyoungwon Jung & Byung Hee Kang

Authors
  1. Donghwan Choi
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  2. Junsik Kwon
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  3. Kyoungwon Jung
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  4. Byung Hee Kang
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Corresponding author

Correspondence to Byung Hee Kang.

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Conflict of interest

All authors have no conflict of interest

Ethical approval

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

Informed consent

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). https://doi.org/10.1007/s00068-022-01909-y

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  • DOI: https://doi.org/10.1007/s00068-022-01909-y

Keywords

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