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European Journal of Trauma and Emergency Surgery
Published in: European Journal of Trauma and Emergency Surgery 4/2015

01-08-2015 | Original Article

Scoring system for traumatic liver injury (SSTLI) in polytraumatic patients: a predictor of mortality

Authors: H. H. Kim, J. H. Kim, C.-Y. Park, H. M. Cho

Published in: European Journal of Trauma and Emergency Surgery | Issue 4/2015

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Abstract

Purpose

The aim of this study was to examine prognostic factors in polytraumatic patients with liver injury and to develop a scoring system for traumatic liver injury (SSTLI) to predict mortality.

Methods

The medical records of 175 patients treated for traumatic liver injury from July 2009 to April 2013 were reviewed. The primary outcome variable was hospital mortality. All risk factors were analyzed by multivariate logistic regression analysis. The SSTLI was created based on the predictive power of each factor.

Results

Age, injury severity score (ISS), trauma and injury severity score, the shock index, and the volume of packed red blood cells transfused were strong predictors of mortality. We hypothesized that the SSTLI would use five clinical measures (total bilirubin, prothrombin time, serum creatinine, age, and ISS). Each measure was scored 0–1 (age and ISS) or 0–3 (total bilirubin, prothrombin time, and creatinine), with 3 indicating the most severe derangement. The receiver-operating characteristic curve of the SSTLI was significant at post-traumatic days 0, 1, 3, and 5 [area under the curve (AUC), 0.830; AUC, 0.912; AUC, 0.941; and AUC, 0.930, respectively]. A value of 5 points was the threshold for reliability dividing low-risk (<5) from high-risk (≥5) patients.

Conclusions

The SSTLI may be available to predict mortality in polytraumatic patients with liver injury, although external validation is needed before widespread implementation.
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Metadata
Title
Scoring system for traumatic liver injury (SSTLI) in polytraumatic patients: a predictor of mortality
Authors
H. H. Kim
J. H. Kim
C.-Y. Park
H. M. Cho
Publication date
01-08-2015
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Trauma and Emergency Surgery / Issue 4/2015
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-014-0454-z

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