Factors affecting the outcome of liver trauma patients with non-operative management in the high care unit of Dr. Soetomo General Hospital Indonesia

Abstract

Link of Video Abstract: https://youtu.be/V8nNXYUrFEY   Background: The liver is the organ that experiences the most trauma when abdominal trauma occurs. Nonoperative management is the primary choice in patients with hepatic trauma with stable hemodynamics and no signs of peritonitis. Various factors that can affect outcomes Methods: This study is a cross-sectional design using medical record data. The study sample was all patients with liver trauma with nonoperative management who met the inclusion and exclusion criteria.  The outcomes assessed were mortality and length of patient hospitalization. Data were analyzed using SPSS version 26.0 for Windows. Results: Over 2 years, 42 patients with liver trauma were treated for nonoperative management. Most patients were male (76.2%) with the age of < 30 years (54.8%). Motorcycle accidents were the most common mechanism (83.3%), with most experiencing grade 4 liver trauma (33.3%). Of the 42 patients, 36 patients (85.7%) were accompanied by trauma to other organs. One mortality was obtained from a total of 42 patients aged ≥ 60 years, grade 5, and accompanied by comorbidities. There was a significant association between age, liver rupture grade, and comorbidity injuries and mortality in patients (p = 0.001; p = 0.01; p = 0.0001).  From the outcome of the length of hospitalization, there is a relationship that tends to be significant between the presence of comorbidity trauma and the length of hospitalization (p = 0.061) Conclusion: Mortality in liver trauma patients with nonoperative management was influenced by age, liver rupture grade, and accompanying injuries. Meanwhile, the length of hospitalization is only affected by comorbidities.