第46回日本集中治療医学会学術集会

Presentation information

English Session

[EngO5] English Session5

Sat. Mar 2, 2019 10:55 AM - 11:55 AM 第11会場 (国立京都国際会館1F Room C-2)

Chair:Hideo Inaba(Department of Circulatory Emergency and Resuscitation Science, Kanazawa University Graduate School of Medicine, Japan)

[EngO5-4] Association of liver enzyme with morbidity and mortality in traumatic liver injur y patients

Ginthasuphang Wangsapthawi, Kaweesak Chittawatanarat (Division of Surgical Critical Care and Trauma, Department of Surgery, Faculty of Medicine, Chiang Mai University, Thailand)

Background: Traumatic liver injury patients can be managed by nonoperative treatment. Unfavorable outcome could occurred after injury, even without obvious symptoms but only abnormal LFT or imaging. Previous studies lacked of change of serum markers at different times after injury and association of the serum marker levels to outcome of patients.
Objective: To compare serum marker in LFT at difference times after traumatic liver injury and identify the serum marker associated with unfavorable outcome
Patients and Methods: Retrospective cohort study in 206 traumatic liver injury patients who were older than 18 years old. The patients’ serum marker datas at difference date after injury were analyzed in favorable outcome and unfavorable outcome groups using statistical significant at p <0.05.
Results: In 206 traumatic liver injuries, the unfavorable outcome group included 119 patients, majority of these patients need interventions. AST and ALT were observed rising along with grading of injury with exception to grade VI injury at first admission. AST was decreasing slower in unfavorable outcome group at day 1-5 and 6-10 periods. TB and DB level were significantly rising after 5 days period of injury and higher than normal in unfavorable group. They had higher OR in especially in day 11-15 period after injury (2.7 and 6.9 with 95% CI = 1.020-7.366 and 1.080-44.037, respectively.)
Conclusion: Liver function test could be used as guided to indicate the patients likely to have complications from traumatic liver injury. Elevated level of TB and DB were significantly associated with unfavorable outcome especially after day 6-15 of injury, while repeating LFT in first five days after injury did not help in determine the patient likely to have unfavorable outcomes. However, normal or slightly abnormal liver function test cannot exclude that the patients were without complication.