Analysis Of Risk Factors Affecting Outcome For Hepatic Trauma

Objective: To analysis the risk factors that affect morbidity and mortality for hepatic trauma and evaluate their clinical significance.Methods: Records of 130 blunt or penetrating hepatic trauma patients in Affiliated of FUJIAN Medical University between 1996 and 2008 were Union Hospital reviewed retrospectively. Data collected included demographics, intraoperative findings, operative management and outcome.Results: In non-operative management group,26 cases were cured and no cases had morbidity and mortality. In operative management group,82 cases were cured and 22 cases died. The Chi-square test was used to assess the influence on morbidity displayed that shock on admission, delay before admission, blood loss, injury mechanism, grade of injury and associated injury were not significantly associated with morbiddity(P> 0.05).And the Chi-square test also was used to assess the influence on mortality displayed that shock on admission, delay before admission, blood loss, injury mechanism, grade of injury were significantly associated with mortality. Then Logistic regression was used to assess the influence on mortality again indicated that shock on admission ( P = 0.015 RR=6.838),blood loss(P=0.013 RR=3.829),injury mechanism(P=0.041 RR=0.144)were statistically significant difference.Conclusions:â‘ It was quite reasonable that the occurrence of morbidity and mortality was far less common during the course of the non-operative management of liver trauma than during operative treatment. Homodynamic stability was the major indication to the non-operative management of liver trauma.â‘¡shock on admission, delay before admission, blood loss, injury mechanism, grade of injury and associated injury were not significantly associated with morbidity. And shock on admission, blood loss, injury mechanism were the independent risk factors that influence the operative mortalityâ‘¢Positive pre-hospital trauma life support and appropriate surgical management, were helpful to reduce operative mortality and morbidity in patients with hepatic trauma.