Low-grade blunt hepatic injury and benefits of intensive care unit monitoring

Jeffrey C. Perumean, Marco Martinez, Rachel Neal, James Lee, Taofeek Olajire-Aro, Jon B. Imran, Brian H. Williams, Herb A. Phelan

Research output: Contribution to journalArticle

Abstract

Background: We investigated low-grade, hemodynamically normal BHI associated with any of three interventions indicating ICU observation. Methods: BHI between 01/01/96-6/30/14 were reviewed. Two groups included: Group A (BHI grades 1-3) with normal initial systolic BP and Group B (all other BHI). Interventions necessitating ICU observation were defined with three criteria: PRC transfusion within 24 h, angiography, or laparotomy. Between group and Group A subgroup outcomes were reported. Results: Group A (n = 1088) had lower ISS, LOS, PRCs transfused, and mortality (p < 0.01) than Group B (n = 636). For any of the criteria indicating ICU admission, Group A had a NPV, sensitivity and specificity of 67.9%, 30.3%, and 75.3% respectively; isolated BHI (n = 188) sensitivity, specificity and NPV were 17.8%, 88.1%, and 77.3%. Laparotomy specifically for BHI was 2.0% for Grade I/II, 4.3% for Grade III subgroups. Conclusions: Hemodynamic stability is insufficient as a sole criterion for safe admission of low-grade BHI to a non-ICU environment.

Original languageEnglish (US)
JournalAmerican Journal of Surgery
DOIs
StateAccepted/In press - 2017

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Nonpenetrating Wounds
Laparotomy
Intensive Care Units
Observation
Sensitivity and Specificity
Liver
Angiography
Hemodynamics
Mortality

Keywords

  • Blunt hepatic/liver injury
  • ICU

ASJC Scopus subject areas

  • Surgery

Cite this

Perumean, J. C., Martinez, M., Neal, R., Lee, J., Olajire-Aro, T., Imran, J. B., ... Phelan, H. A. (Accepted/In press). Low-grade blunt hepatic injury and benefits of intensive care unit monitoring. American Journal of Surgery. https://doi.org/10.1016/j.amjsurg.2017.09.003

Low-grade blunt hepatic injury and benefits of intensive care unit monitoring. / Perumean, Jeffrey C.; Martinez, Marco; Neal, Rachel; Lee, James; Olajire-Aro, Taofeek; Imran, Jon B.; Williams, Brian H.; Phelan, Herb A.

In: American Journal of Surgery, 2017.

Research output: Contribution to journalArticle

Perumean, Jeffrey C. ; Martinez, Marco ; Neal, Rachel ; Lee, James ; Olajire-Aro, Taofeek ; Imran, Jon B. ; Williams, Brian H. ; Phelan, Herb A. / Low-grade blunt hepatic injury and benefits of intensive care unit monitoring. In: American Journal of Surgery. 2017.
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AU - Imran, Jon B.

AU - Williams, Brian H.

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