Observational studyUpdates in surgery2022
Predictive factors of non-operative management failure in 494 blunt liver injuries: a multicenter retrospective study.
Observational study in Updates in surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Safety and effectiveness of nonoperative management in liver lacerations: a retrospective cohort study.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2026Observational
- Selective non-operative management of traumatic liver injury in Palestine: a retrospective single-center cohort study.Frontiers in medicine · 2026Article
- Injectable hemostatic foam hydrogel for traumatic intra-abdominal hemorrhage.Materials today. Bio · 2025Article
- High-grade liver injury: outcomes with a trauma surgery-liver surgery collaborative approach.Trauma surgery & acute care open · 2025Article
- Future Perspectives on Radiomics in Acute Liver Injury and Liver Trauma.Journal of personalized medicine · 2024Review
- A 21-Year-Old Man with Previous History of Gastrectomy, Cholecystectomy, and Biliary Stenting with Failed Non-Operative Management of Blunt Trauma to the Liver Due to Traumatic Stent Perforation.The American journal of case reports · 2023Article
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Authors and funding
11 authors.
Funding
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Abstract
Non-operative management (NOM) has become the major treatment of blunt liver trauma (BLT) with a NOM failure rate of 3-15% due to liver-related complications. The aim of the study was to determine the predictive factors and a risk-stratified score of NOM failure. From 2013 to 2021, all patients with BLT in three trauma centers were included; clinical, biological, radiological and outcome data were retrospectively analyzed. Predictive factors and a risk-stratified score associated with NOM failure were identified. Four hundred and ninety-four patients with BLT were included. Among them, 80 (16.2%) had isolated BLT. Fifty-nine patients (11.9%) underwent emergent operative management (OM) on the day of admission and 435 (88.1%) had a NOM. NOM failure rate was 11.5%. Patients with a NOM failure more frequently had a hemoperitoneum (p < 0.001), liver bleeding (p < 0.001), blood transfusion (p < 0.001) and angioembolization (p < 0.001) compared to patient with a successful NOM. In multivariate analysis, the presence of hemoperitoneum (OR = 5.71; 95 CI [1.29-25.45]), angioembolization (OR = 8.73; 95 CI [2.04-38.44] and severe liver injury (AAST IV or V) (OR = 8.97; 95 CI [3.36-23.99]) were independent predictive factors of NOM failure. When these three factors were associated, NOM failure rate was 83.3%. The AAST grade, the presence of hemoperitoneum and the realization of liver angioembolization on the day of admission are three independent predictive factors of NOM failure. Our risk-score based on these three factors stratify the risk of NOM failure in BLT and could be used for a more appropriate level of medical survey adapted to each patient. Level of evidence: prospective observational cohort study, Level III.
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