Demographic Profile of Liver Injury Managed at a Tertiary Care Hospital in Central Nepal -A Retrospective Study

  • Narayan Prasad Belbase College of Medical Sciences, Bharatpur, Chitwan
  • Aditya Kumar Jalan College of Medical Sciences
  • Hari Upadhyay College of medical Sciences
  • Rohit Mishra College of Medical Sciences
  • Mukesh Karki College of Medical Sciences
  • Sujit Kumar College of Medical Sciences
Keywords: Liver injury, non-operative management, operative management.

Abstract

Background & Objectives:

The liver is one of the commonly injured solid organ following abdominal trauma. The aim of this study was to determine the outcome of liver injuries managed operatively or non-operatively and predict factors affecting morbidity and mortality.

Materials & Methods:

This was a retrospective study of 40 liver injuries managed in the department of Surgical Gastroenterology at College of Medical Sciences over a period of 2 years. The liver injury was classified in accordance with the American Association for the Surgery of Trauma liver injury scoring scale. Patients were divided into two groups those managed operatively or non-operatively and were compared in terms of demographic profile and outcome.

Results:

Forty patients were analyzed. The mean age of the patients was 29.95years. Male predominance was seen with 72.5% of the cases. Road traffic accidents were the commonest mode of injury seen in 72.5% cases. The mean Revised Trauma Score (RTS) and Injury severity score (ISS)  were 7.11and 22.58. The mean systolic BP, hospital stay and ICU stay were 93.80 mm of mercury, 11.55 days and 3.55 days respectively. Twenty six patients (65%) were initially managed non-operatively and 14 patients were managed operatively. Five patients had to be converted to operative management for hemodynamic instability. Mortality was 7.6% in patient undergoing non-operative management and 21.43% in patients managed operatively. Low systolic BP at presentation, low RTS score, high ISS score, high AST, ALT and prothrombin time were significantly associated with operative management and mortality.

Conclusion:

Patients with hemodynamic instability, low RTS score, high ISS score, high liver enzymes have high likelihood of operative management.

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Author Biographies

Narayan Prasad Belbase, College of Medical Sciences, Bharatpur, Chitwan
Lecturer,Department of General Surgery and Surgical Gastroenterology
Aditya Kumar Jalan, College of Medical Sciences
Resident,General Surgery
Hari Upadhyay, College of medical Sciences
Lecturer,department of Community Medicine
Rohit Mishra, College of Medical Sciences
Lecturer, Department of General Surgery
Mukesh Karki, College of Medical Sciences
Resident,General Surgery
Sujit Kumar, College of Medical Sciences
Associate professor, Department of General Surgery and Surgical Gastroenterology
Published
2018-03-30
How to Cite
Belbase, N., Jalan, A., Upadhyay, H., Mishra, R., Karki, M., & Kumar, S. (2018). Demographic Profile of Liver Injury Managed at a Tertiary Care Hospital in Central Nepal -A Retrospective Study. Journal of College of Medical Sciences-Nepal, 14(1), 32-38. https://doi.org/10.3126/jcmsn.v14i1.18884
Section
Original Articles