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CLINICAL AND PARACLINICAL CHARACTERISTICS AND TREATMENT OUTCOMES OF MULTIPLE TRAUMA WITH LIVER INJURY IN THE INTENSIVE CARE UNIT OF MILITARY HOSPITAL 175
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Abstract
Objective: To describe the clinical and paraclinical characteristics, analyze associated factors, and evaluate treatment outcomes of multiple trauma with liver injury in the Intensive Care Unit of 175 Military Hospital. Subjects and Methods: A descriptive retrospective and prospective analytical study was conducted on 62 patients diagnosed with multiple trauma and liver injury from December 2023 to December 2024. Results: Among 62 patients, the majority were male (83.9%) with a mean age of 36.5 ± 12.7 years. Road traffic accidents were the leading cause (80.6%). The overall mortality rate was 25.8%, mainly due to extrahepatic causes (21%). Patients with AAST grade IV–V liver injuries had higher mortality rates (36.8% and 80%, respectively). The mortality group had significantly higher ISS scores (58.2 ± 11.1 vs. 39.5 ± 9.8), higher incidence of shock, elevated blood lactate (≥5 mmol/L), and more severe liver and kidney dysfunction (p < 0.05). Multivariate analysis identified ISS ≥50 (OR = 3.08), traumatic shock (OR = 2.94), and lactate ≥5 mmol/L (OR = 4.47) as independent prognostic factors. Non-operative management resulted in the highest survival rate (90.9%), whereas surgical treatment was associated with the highest mortality (62.5%). Conclusion: High-grade liver injuries (AAST grade IV–V) accompanied by hemodynamic instability, elevated lactate, and high ISS significantly increase the risk of mortality. Early identification of these factors allows for better prognostic assessment and supports the selection of appropriate treatment strategies, prioritizing non-operative management when feasible.
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Keywords
Multiple trauma, liver injury, non-operative management.
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