Abstract
Hepatic trauma classification according to the Japanese Association for the Surgery of Trauma was classified by the morphological pattern of liver injury, so that it does not always indicate the severity of liver injury. We reviewed 58 cases of hepatic trauma transferred to the Emergency Center in Showa University Fujigaoka Hospital from 1985 to 1998 to compare the hepatic trauma classification with liver function tests and to investigate the prognostic risk factors for hepatic trauma.
Data of the liver function tests including AST, ALT, prothrombin time, hepaplastin test, and CT volumetry for liver injury did not increase parallel to the grade increase in hepatic trauma classification. Significant risk factors for prognosis in hepatic trauma were age, systolic blood pressure, injury severity score, hospital stay periods, prothrombin time, hepaplastin test, and bleeding volume on laparotomy whereas significant risk factors in hepatic trauma of IIIb were only prothrombin time, hepaplastin test, and bleeding volume on laparotomy.Analysis of dead cases indicated that bleeding was the major cause of death in most cases.
Results suggest that Japanese hepatic trauma classification does not always indicate the severity of liver injury, that prothrombin time and hepaplastin test on arrival may be significant prognostic risk factors for liver injury, and that control of bleding is the most inported treatment for hepatic trauma.
