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

Choi, D  | Kwon, J  | Jung, K  | Kang, BH
European journal of trauma and emergency surgery, 48(4). : 3349-3355, 2022
Journal Title
European journal of trauma and emergency surgery
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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Journal Papers > School of Medicine / Graduate School of Medicine > Surgery
Ajou Authors
강, 병희  |  권, 준식  |  정, 경원  |  최, 동환
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