Operative Treatment of Hepatic Injuries in Buriram Hospital
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Abstract
Background: Hepatic injuries were the major cause of death of patients with abdominal injuries. Operative treatment are varies to control massive haemorrhage.
Objective: To determine outcomes of patient with hepatic injuries and factors associated outcomes.
Setting: Buriram Hospital during January 2003 to December 2006.
Study Design: Descriptive retrospective study.
Material and Methods: Eighty-seven medical records of patients with hepatic injuries were studied. General data, sex, age, severity of injuries, associated injuries and outcomes were recorded. All data were analyzed with descriptive analysis and were presented with mean, SD, percentage.
Results: Most of patients were male (71.3%). Patients mainly affected were decade of life (45.9%) with an age range of 2 to 65 years old (mean 26.1 ± 9.8). Seventy nine point three percent were resulted from blunt trauma and 20.7% from penetrating injuries. There were 29 (33.3%), 29 (33.3%), 20 (23%), 6 (6.9%), 3 (3.5%) and 0 (0%) patients with hepatic injury grade I, II, III, IV, V and VI, respectively. Operative treatment of hepatic injuries were varied according to degree of injuries amenable to relatively simple operative treatment. Perihepatic packing was used for treatment of 66.7% of high grade hepatic injuries. The results were 40 patients had complication (morbidity 46%) and 14 patients died (mortality 16.1%). Eight patients (9.2%) died due to hepatic cause, whereas 6 patients (6.9%) died of non hepatic causes. Exsanguinations and associated injuries were the majors cause of death (78.6%). The factors related mortality rate were hypovolemic shock, blunt injury, associated injuries and higher grade hepatic injury (p < 0.005).
Conclusion: Patients with hepatic injuries were high mortality rate, many factors were
related outcomes. To reduce mortality and morbidity rate, we should establish effective accidental prevention program and pre-hospital care.
Keywords: hepatic injury, hepatic injury grade, Operative treatment, outcomes
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References
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