Krstina Doklestic Vasiljev (Belgrade / RS), Zlatibor Loncar (Belgrade / RS), Zoran Bukumiric (Belgrade / RS), Pavle Gregoric (Belgrade / RS), Dusan Micic (Belgrade / RS), Nenad Ivancevic (Belgrade / RS), Miljan Ceranic (Belgrade / RS), Ognjen Duka (Belgrade / RS), Jelena Mitrovic (Belgrade / RS), Ivana Lesevic (Belgrade / RS), Dusan Brkic (Belgrade / RS), Nikica Grubor (Belgrade / RS), Danijel Galun (Belgrade / RS), Zlatko Perisic (Belgrade / RS), Bojan Jovanovic (Belgrade / RS), Dragan Vasin (Belgrade / RS)
Abstract text (incl. references and figure legends)
Introduction Patients who have multiple associated severe injuries are still extremely demanding to treat which raises the old question of which are the most important predictors of the outcome Material and Methods Study analysis included 21 variables to predicting outcomes in polytraumatized patient (Injury Severity Score, ISS ≥15) with associated liver trauma (World Society of Emergency Surgery, WSES I-IV, American Association for the Surgery of Trauma, AAST-OIS II -V). Results The mean age was 41.86 ± 17.93 years. In 74 (55.6%) patients liver injury was severe. Liver trauma was treated by non-operative management (NOM) in 81 (60.9%), single laparotomy 35(26.3%) and Damage Control Surgery (DCS) 17(12.8%). Associated injuries were spleen 93 (69.9%), 10 (7.5%) pancreas, 9(6.8%) kidney, 20 (15%) intestines injuries; neurosurgical 34 (25.6%), orthopedic 54 (40.6%) and 70 (52.6%) thoracic. Considering Clavien-Dindo classification 34(25.6%) patients had complications grade III, 54 (40.6%) grade IV and 28 (21.1%) grade V. In the multivariate logistic regression model with preoperative predictors, statistically significant predictors of death were severe liver injury compared to mild liver injury (OR=11.3; p<0.001) and sustained neurosurgical injuries (OR=5.3; p=0.002). In the multivariate logistic regression model with operative predictors, statistically significant predictors of death were Massive Blood Transfusion (OR=30.5; p<0.001) and relaparotomies (OR=51.2; p=0.002). Conclusions In this study patients with severe liver injury have more than 11 times greater chance of death comparing with other factors, which represents the severity of liver trauma as the most significant predictor of outcome in polytrauma. References 1. Adnan, S.M. et al. Outcomes following abdominal trauma in Scotland. Eur J Trauma Emerg Surg 47, 1713–1719 (2021). https://doi.org/10.1007/s00068-019-01146-w
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