J Korean Soc Traumatol Search

CLOSE


J Trauma Inj > Epub ahead of print
DOI: https://doi.org/10.20408/jti.2021.0009    [Epub ahead of print]
Published online September 7, 2021.
Validity of the Scoring System for Traumatic Liver Injury: A Generalized Estimating Equation Analysis
Kangho Lee1,2, Dongyeon Ryu1,2, Hohyun Kim1,2,3, Chang Ho Jeon4, Jae Hun Kim1,2, Chan Yong Park5, Seok Ran Yeom2,3,6
1Department of Trauma and Surgical Critical Care, Pusan National University Hospital, Busan, Korea
2Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
3Department of Emergency Medicine, Pusan National University School of Medicine, Yangsan, Korea
4Department of Diagnostic Radiology, The Catholic University of Korea Eunpyeong St. Mary's Hospital, Seoul, Korea
5Department of Trauma Surgery, Seoul National University Hospital, Seoul, Korea
6Department of Emergency Medicine, Pusan National University Hospital, Busan, Korea
Correspondence:  Hohyun Kim, Tel: +82-51-240-7369, Fax: +82-51-240-7719, 
Email: traumagskhh@naver.com
Received: 15 January 2021   • Revised: 17 February 2021   • Accepted: 11 March 2021
Abstract
Purpose
The scoring system for traumatic liver injury (SSTLI) was developed in 2015 to predict mortality in patients with polytraumatic liver injury. This study aimed to validate the SSTLI as a prognostic factor in patients with polytrauma and liver injury through a generalized estimating equation (GEE) analysis.
Methods
The medical records of 521 patients with traumatic liver injury from January 2015 to December 2019 were reviewed. The primary outcome variable was in-hospital mortality. All the risk factors were analysed using multivariate logistic regression analysis. The SSTLI has five clinical measures (age, Injury Severity Score [ISS], serum total bilirubin level, prothrombin time, and creatinine level) chosen based on their predictive power. Each measure is scored as 0–1 (age and ISS) or 0–3 (serum total bilirubin level, prothrombin time, and creatinine level). The SSTLI score corresponds to the total points for each item (0–11 points).
Results
The areas under the curve of the SSTLI to predict mortality on post-traumatic days 0, 1, 3, and 5 were 0.736, 0.783, 0.830, and 0.824, respectively. A very good to excellent positive correlation was observed between the probability of mortality and the SSTLI score (γ=0.997, p<0.001). A value of 5 points was used as the threshold to distinguish low-risk (<5) from high-risk (≥5) patients. Multivariate analysis using the GEE in the logistic regression model indicated that the SSTLI score was an independent predictor of mortality (odds ratio 1.027; 95% confidence interval 1.018–1.036; p<0.001).
Conclusions
The SSTLI was verified to predict mortality in patients with polytrauma and liver injury. A score of ≥5 on the SSTLI indicated a high risk of post-traumatic mortality.
Key Words: Wounds and injuries; Liver; Trauma severity indices; Prognosis


ABOUT
ARTICLE CATEGORY

Browse all articles >

BROWSE ARTICLES
EDITORIAL POLICY
FOR CONTRIBUTORS
Editorial Office
Department of Trauma Surgery, Gachon University Gil Medical Center
783 Namdong-daero, Namdong-gu, Incheon 21556, Korea
Tel: +82-10-5552-2653    Fax: +82-70-8677-6333    E-mail: office@jtraumainj.org                

Copyright © 2021 by The Korean Society of Traumatology.

Developed in M2PI

Close layer
prev next