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The rate of success of the conservative management of liver trauma in a developing country
BACKGROUND: The conservative treatment of liver trauma has made important progress over the last 10 years at the Trauma University Hospital in Tirana, Albania. The percentage of success was 58.7%. The aims of this study were to analyze the conservative treatment of liver trauma and to compare the re...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5463417/ https://www.ncbi.nlm.nih.gov/pubmed/28596799 http://dx.doi.org/10.1186/s13017-017-0135-4 |
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author | Buci, S. Torba, M. Gjata, A. Kajo, I. Bushi, Gj. Kagjini, K. |
author_facet | Buci, S. Torba, M. Gjata, A. Kajo, I. Bushi, Gj. Kagjini, K. |
author_sort | Buci, S. |
collection | PubMed |
description | BACKGROUND: The conservative treatment of liver trauma has made important progress over the last 10 years at the Trauma University Hospital in Tirana, Albania. The percentage of success was 58.7%. The aims of this study were to analyze the conservative treatment of liver trauma and to compare the results with those in the literature. METHODS: This study was conducted prospectively from January 2009 to December 2012. We analyzed 173 patients admitted to our hospital with liver trauma. Liver injuries were evaluated according to the American Association for the Surgery of Trauma and the World Society of Emergency Surgery classification, while the anatomic gravity of the associated injuries was defined using the Injury Severity Score system. The potential mortality was estimated with the Revised Trauma Score. RESULTS: Out of the 173 patients with liver trauma, 83.2% were male. The main cause of liver trauma was motor vehicle crashes (50.9%). Blunt trauma was the cause of liver injury in 129 cases (74.6%), and penetrating trauma occurred in 44 cases (25.4%). Initially, the decision was to manage 88 cases (50.9%) via the conservative approach. Of these, 73 cases (42.2%) were successfully treated with conservative treatment, while in 15 cases (17.2%), this approach failed. The success rate of conservative treatment by grade of injuries was as follows: grade I (38.4%), grade II (30.1%), grade III (28.8%), and grade IV (2.7%). The likelihood of the success of conservative treatment had a significant correlation with the grade of the liver injury (p < 0.00001), associated intra-abdominal injuries (p = 0.00051), and complications (z = 2.3169, p = 0.02051). The overall mortality rate of liver trauma was 13.2%. CONCLUSIONS: The likelihood of success in using conservative treatment had a significant correlation with the grade of liver injury and associated intra-abdominal injuries. The limited hospital resources and low level of consensus on conservative treatment had a negative impact on the level of success. |
format | Online Article Text |
id | pubmed-5463417 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-54634172017-06-08 The rate of success of the conservative management of liver trauma in a developing country Buci, S. Torba, M. Gjata, A. Kajo, I. Bushi, Gj. Kagjini, K. World J Emerg Surg Research Article BACKGROUND: The conservative treatment of liver trauma has made important progress over the last 10 years at the Trauma University Hospital in Tirana, Albania. The percentage of success was 58.7%. The aims of this study were to analyze the conservative treatment of liver trauma and to compare the results with those in the literature. METHODS: This study was conducted prospectively from January 2009 to December 2012. We analyzed 173 patients admitted to our hospital with liver trauma. Liver injuries were evaluated according to the American Association for the Surgery of Trauma and the World Society of Emergency Surgery classification, while the anatomic gravity of the associated injuries was defined using the Injury Severity Score system. The potential mortality was estimated with the Revised Trauma Score. RESULTS: Out of the 173 patients with liver trauma, 83.2% were male. The main cause of liver trauma was motor vehicle crashes (50.9%). Blunt trauma was the cause of liver injury in 129 cases (74.6%), and penetrating trauma occurred in 44 cases (25.4%). Initially, the decision was to manage 88 cases (50.9%) via the conservative approach. Of these, 73 cases (42.2%) were successfully treated with conservative treatment, while in 15 cases (17.2%), this approach failed. The success rate of conservative treatment by grade of injuries was as follows: grade I (38.4%), grade II (30.1%), grade III (28.8%), and grade IV (2.7%). The likelihood of the success of conservative treatment had a significant correlation with the grade of the liver injury (p < 0.00001), associated intra-abdominal injuries (p = 0.00051), and complications (z = 2.3169, p = 0.02051). The overall mortality rate of liver trauma was 13.2%. CONCLUSIONS: The likelihood of success in using conservative treatment had a significant correlation with the grade of liver injury and associated intra-abdominal injuries. The limited hospital resources and low level of consensus on conservative treatment had a negative impact on the level of success. BioMed Central 2017-06-07 /pmc/articles/PMC5463417/ /pubmed/28596799 http://dx.doi.org/10.1186/s13017-017-0135-4 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Buci, S. Torba, M. Gjata, A. Kajo, I. Bushi, Gj. Kagjini, K. The rate of success of the conservative management of liver trauma in a developing country |
title | The rate of success of the conservative management of liver trauma in a developing country |
title_full | The rate of success of the conservative management of liver trauma in a developing country |
title_fullStr | The rate of success of the conservative management of liver trauma in a developing country |
title_full_unstemmed | The rate of success of the conservative management of liver trauma in a developing country |
title_short | The rate of success of the conservative management of liver trauma in a developing country |
title_sort | rate of success of the conservative management of liver trauma in a developing country |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5463417/ https://www.ncbi.nlm.nih.gov/pubmed/28596799 http://dx.doi.org/10.1186/s13017-017-0135-4 |
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