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European Journal of Trauma and Emergency Surgery
Published in: European Journal of Trauma and Emergency Surgery 4/2022

14-02-2022 | Angiography | Original Article

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

Authors: Donghwan Choi, Junsik Kwon, Kyoungwon Jung, Byung Hee Kang

Published in: European Journal of Trauma and Emergency Surgery | Issue 4/2022

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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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Metadata
Title
Improvement of mortality in severe liver injury after trauma center implementation: a propensity score matched study
Authors
Donghwan Choi
Junsik Kwon
Kyoungwon Jung
Byung Hee Kang
Publication date
14-02-2022
Publisher
Springer Berlin Heidelberg
Keyword
Angiography
Published in
European Journal of Trauma and Emergency Surgery / Issue 4/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-022-01909-y

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