Trauma hepático: uma experiência de 21 anos

Thiago Messias Zago,Maria Silveira Carvalho Alves,Bruno Monteiro Pereira,Thiago Rodrigues Araujo Calderan,Gustavo Pereira Fraga,Bartolomeu Nascimento

doi:10.1590/s0100-69912013000400011

Thiago Messias Zago, Maria Silveira Carvalho Alves + Show 4 more

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https://doi.org/10.1590/s0100-69912013000400011

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To evaluate the epidemiological aspects, behavior, morbidity and treatment outcomes for liver trauma. We conducted a retrospective study of patients over 13 years of age admitted to a university hospital from 1990 to 2010, submitted to surgery or nonoperative management (NOM). 748 patients were admitted with liver trauma. The most common mechanism of injury was penetrating trauma (461 cases, 61.6%), blunt trauma occurring in 287 patients (38.4%). According to the degree of liver injury (AAST-OIS) in blunt trauma we predominantly observed Grades I and II and in penetrating trauma, Grade III. NOM was performed in 25.7% of patients with blunt injury. As for surgical procedures, suturing was performed more frequently (41.2%). The liver-related morbidity was 16.7%. The survival rate for patients with liver trauma was 73.5% for blunt and 84.2% for penetrating trauma. Mortality in complex trauma was 45.9%. trauma remains more common in younger populations and in males. There was a reduction of penetrating liver trauma. NOM proved safe and effective, and often has been used to treat patients with penetrating liver trauma. Morbidity was high and mortality was higher in victims of blunt trauma and complex liver injuries.

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The main cause of death among individuals under 40 years old is traumatic injury, largely as a result of increasing numbers of motor vehicle crashes and urban violence
The diagnosis and treatment of hepatic trauma has evolved with the use of computerized tomography (CT), and the likelihood of non-operative management for selected hemodynamically stable patients has become a reality in many trauma centers worldwide
This study aims to evaluate the epidemiological aspects of hepatic trauma in a university teaching hospital during a 21-year period, including causes of trauma, severity of injuries, treatments and outcomes

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Introduction

The main cause of death among individuals under 40 years old is traumatic injury, largely as a result of increasing numbers of motor vehicle crashes and urban violence. This study aims to evaluate the epidemiological aspects of hepatic trauma in a university teaching hospital during a 21-year period, including causes of trauma, severity of injuries, treatments and outcomes. Zago Hepatic trauma: a 21-year experience parameters were analyzed: age, gender, cause of injury, systolic blood pressure (SBP), Glasgow Coma Scale (GCS) Revised Trauma Score (RTS), presence of associated abdominal injuries, Injury Severity Score (ISS), probability of survival – TRISS, AAST-OIS grade of injury, surgical management, length of hospital stay (LOS), complications related and non-related to the liver and mortality rate [69].

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