Management of liver trauma in urban university hospitals in India: an observational multicentre cohort study

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Management of liver trauma in urban university hospitals in India: an observational multicentre cohort study


JournalWorld Journal of Emergency Surgery
Publication date – Oct – 2020
Authors – Yash Sinha, Monty U Khajanchi, Ramlal P Prajapati, Satish Dharap, Kapil Dev Soni, Vineet Kumar, Santosh Mahindrakar, Nobhojit Roy
KeywordsEpidemiology of liver injury, Injury, Liver injury, Management, Non-operative management
Open access – Yes
SpecialityEmergency surgery, General surgery, Trauma and orthopaedic surgery, Trauma surgery
World region South-eastern Asia
Country: India
Language – English
Submitted to the One Surgery Index on November 7, 2020 at 6:55 pm
Abstract:

Background
Low- and middle-income countries (LMICs) contribute to 90% of injuries occurring in the world. The liver is one of the commonest organs injured in abdominal trauma. This study aims to highlight the demographic and management profile of liver injury patients, presenting to four urban Indian university hospitals in India.

Methods
This is a retrospective registry-based study. Data of patients with liver injury either isolated or concomitant with other injuries was used using the ICD-10 code S36.1 for liver injury. The severity of injury was graded based on the World Society of Emergency Surgery (WSES) grading for liver injuries.

Results
A total of 368 liver injury patients were analysed. Eighty-nine percent were males, with road traffic injuries being the commonest mechanism. As per WSES liver injury grade, there were 127 (34.5%) grade I, 96 (26.1%) grade II, 70 (19.0%) grade III and 66 (17.9%) grade IV injuries. The overall mortality was 16.6%. Two hundred sixty-two patients (71.2%) were managed non-operatively (NOM), and 106 (38.8%) were operated. 90.1% of those managed non-operatively survived.

Conclusion
In this multicentre cohort of liver injury patients from urban university hospitals in India, the commonest profile of patient was a young male, with a blunt injury to the abdomen due to a road traffic accident. Success rate of non-operative management of liver injury is comparable to other countries.

OSI Number – 20718
PMID – 33059728

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