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Experience of non-operative management of blunt liver trauma at Hospital das Clínicas de Uberlândia: 114 cases

INTRODUCTION: trauma is the leading cause of death for the age group from 1 to 49 years in Brazil. Non-Operative Management (NOM) is the gold standard in trauma centers and does not affect mortality in comparison to operative treatment. METHODS: medical records were reviewed for 114 patients with bl...

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Autores principales: FERNANDES, GABRIELA SOUZA, MARTINS, MURILO CÂNDIDO, GOMES, HEITOR LUIZ
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Colégio Brasileiro de Cirurgiões 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10519691/
https://www.ncbi.nlm.nih.gov/pubmed/36921133
http://dx.doi.org/10.1590/0100-6991e-20233424-en
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author FERNANDES, GABRIELA SOUZA
MARTINS, MURILO CÂNDIDO
GOMES, HEITOR LUIZ
author_facet FERNANDES, GABRIELA SOUZA
MARTINS, MURILO CÂNDIDO
GOMES, HEITOR LUIZ
author_sort FERNANDES, GABRIELA SOUZA
collection PubMed
description INTRODUCTION: trauma is the leading cause of death for the age group from 1 to 49 years in Brazil. Non-Operative Management (NOM) is the gold standard in trauma centers and does not affect mortality in comparison to operative treatment. METHODS: medical records were reviewed for 114 patients with blunt liver trauma treated at Hospital das Clínicas of the Federal University of Uberlândia (HC-UFU) from November 2015 to November 2020. RESULTS: the most prevalent gender was masculine (74.5%). The most prevalent age group was 20 to 49 years (65.7%). The majority of admitted patients (60.5%) had an Injury Severity Score (ISS) of more than 15. On hospital admission, 30.7% had HR above 100 bpm and 30.70% had SBP below 100mmHg. NOM was implemented in 77.2% of patients, the failure rate was 11.36% and the specific failure rate, excluding complications of associated injuries that resulted in surgery, was 1.75%. One third of deaths were due to severe traumatic brain injury. CONCLUSION: the failure rate of NOM in this study is similar to the literature reports for liver trauma. The failure rate, excluding complications of associated injuries, is considered low. The recognition of the epidemiological profile of patients admitted at HC-UFU allows multidisciplinary and integrated care with specialized training, as well as the development of institutional protocols, aiming to reduce morbidity and mortality related to hepatic trauma.
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spelling pubmed-105196912023-09-26 Experience of non-operative management of blunt liver trauma at Hospital das Clínicas de Uberlândia: 114 cases FERNANDES, GABRIELA SOUZA MARTINS, MURILO CÂNDIDO GOMES, HEITOR LUIZ Rev Col Bras Cir Original Article INTRODUCTION: trauma is the leading cause of death for the age group from 1 to 49 years in Brazil. Non-Operative Management (NOM) is the gold standard in trauma centers and does not affect mortality in comparison to operative treatment. METHODS: medical records were reviewed for 114 patients with blunt liver trauma treated at Hospital das Clínicas of the Federal University of Uberlândia (HC-UFU) from November 2015 to November 2020. RESULTS: the most prevalent gender was masculine (74.5%). The most prevalent age group was 20 to 49 years (65.7%). The majority of admitted patients (60.5%) had an Injury Severity Score (ISS) of more than 15. On hospital admission, 30.7% had HR above 100 bpm and 30.70% had SBP below 100mmHg. NOM was implemented in 77.2% of patients, the failure rate was 11.36% and the specific failure rate, excluding complications of associated injuries that resulted in surgery, was 1.75%. One third of deaths were due to severe traumatic brain injury. CONCLUSION: the failure rate of NOM in this study is similar to the literature reports for liver trauma. The failure rate, excluding complications of associated injuries, is considered low. The recognition of the epidemiological profile of patients admitted at HC-UFU allows multidisciplinary and integrated care with specialized training, as well as the development of institutional protocols, aiming to reduce morbidity and mortality related to hepatic trauma. Colégio Brasileiro de Cirurgiões 2023-02-17 /pmc/articles/PMC10519691/ /pubmed/36921133 http://dx.doi.org/10.1590/0100-6991e-20233424-en Text en © 2023 Revista do Colégio Brasileiro de Cirurgiões https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License
spellingShingle Original Article
FERNANDES, GABRIELA SOUZA
MARTINS, MURILO CÂNDIDO
GOMES, HEITOR LUIZ
Experience of non-operative management of blunt liver trauma at Hospital das Clínicas de Uberlândia: 114 cases
title Experience of non-operative management of blunt liver trauma at Hospital das Clínicas de Uberlândia: 114 cases
title_full Experience of non-operative management of blunt liver trauma at Hospital das Clínicas de Uberlândia: 114 cases
title_fullStr Experience of non-operative management of blunt liver trauma at Hospital das Clínicas de Uberlândia: 114 cases
title_full_unstemmed Experience of non-operative management of blunt liver trauma at Hospital das Clínicas de Uberlândia: 114 cases
title_short Experience of non-operative management of blunt liver trauma at Hospital das Clínicas de Uberlândia: 114 cases
title_sort experience of non-operative management of blunt liver trauma at hospital das clínicas de uberlândia: 114 cases
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10519691/
https://www.ncbi.nlm.nih.gov/pubmed/36921133
http://dx.doi.org/10.1590/0100-6991e-20233424-en
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