[Liver trauma. Description of a cohort and evaluation of therapeutic options]. / Traumatismo hepático. Descripción de una cohorte y valoración de opciones terapéuticas.

INTRODUCTION: Complex liver injuries carry high morbidity and mortality ranging between 40 and 80%. OBJECTIVES: To describe the characteristics of patients with liver trauma in the intensive care unit of our hospital, and the causes, severity scales, diagnoses, and treatments of these injuries, as well as length of hospital stay, morbidity and mortality. PATIENTS AND METHOD: We retrospectively reviewed the patients with liver trauma admitted to our intensive care unit (ICU) from January 2000 to December 2005. There were two groups of patients: those who underwent surgery and those who received conservative treatment. RESULTS: Univariate analysis revealed statistically significant differences between the two groups in the Acute Physiology and Chronic Health Evaluation II (APACHE II) score on admission to the ICU, the Injury Severity Score (ISS), and the percentage of severelesions according to the Liver Injury Scale (LIS), as well as in the coexistence of lesions in the large intestine. CONCLUSIONS: From the statistical point of view, the two main variables guiding the therapeutic approach were hemodynamic instability and the need for transfusion. The indication for surgery showed a clear, although non-significant, association with mortality. Lastly, there was an association between the surgical option of packing and mortality.

Traumatismo hepático. Descripción de una cohorte y valoración de opciones terapéuticas / Liver trauma. Description of a cohort and evaluation of therapeutic options

Objetivos. Describir las características de los pacientes con traumatismo hepático ingresados en la Unidad de Cuidados Intensvos (UCI) de nuestro hospital, los mecanismos lesionales, las escalas de gravedad, los diagnósticos y los tratamientos, así como la estancia hospitalaria y la morbimortalidad. Pacientes y método. Se han analizado de forma retrospectiva los casos de traumatismo hepático que ingresaron en nuestra unidad de cuidados intensivos desde enero de 2000 hasta diciembre de 2005. Se diferenciaron dos grupos de pacientes según la opción terapéutica utilizada: pacientes intervenidos quirúrgicamente y pacientes tratados de forma conservadora. Resultados. Comparando las características de los pacientes sometidos a uno u otro tipo de tratamiento, comprobamos, mediante análisis univariable, que hubo diferencias estadísticamente significativas entre ambos grupos en la puntuación de la escala de gravedad APACHE II al ingreso en UCI, el Injury Severity Score (ISS), el porcentaje de lesiones hepáticas graves según la Liver Injury Scale (LIS), así como la concomitancia de lesión en el intestino grueso relacionada. Conclusiones. La inestabilidad hemodinámica y la necesidad de transfusión han sido, desde el punto de vista estadístico, las dos principales variables en las que se apoyó la decisión de la opción terapéutica que desarrollar. La indicación quirúrgica sin llegar a la significación estadística presenta una clara tendencia a tener relación con la mortalidad. Por último, también encontramos asociación entre la opción quirúrgica de realizar packing y mortalidad (AU)

Introduction. Complex liver injuries carry high morbidity and mortality ranging between 40 and 80%. Objectives. To describe the characteristics of patients with liver trauma in the intensive care unit of our hospital, and the causes, severity scales, diagnoses, and treatments of these injuries, as well as length of hospital stay, morbidity and mortality. Patients and method. We retrospectively reviewed the patients with liver trauma admitted to our intensive care unit (ICU) from January 2000 to December 2005. There were two groups of patients: those who underwent surgery and those who received conservative treatment. Results. Univariate analysis revealed statistically significant differences between the two groups in the Acute Physiology and Chronic Health Evaluation II (APACHE II) score on admission to the ICU, the Injury Severity Score (ISS), and the percentage of severelesions according to the Liver Injury Scale (LIS), as well as in the coexistence of lesions in the large intestine. Conclusions. From the statistical point of view, the two main variables guiding the therapeutic approach were hemodynamic instability and the need for transfusion. The indication for surgery showed a clear, although non-significant, association with mortality. Lastly, there was an association between the surgical option of packing and mortality (AU)