TY  - JOUR
PY  - 2015//
TI  - Angiointervention: an independent predictor of survival in high-grade blunt liver injuries
JO  - American journal of surgery
A1  - Sivrikoz, Emre
A1  - Teixeira, Pedro G.
A1  - Resnick, Shelby
A1  - Inaba, Kenji
A1  - Talving, Peep
A1  - Demetriades, Demetrios
SP  - 742
EP  - 746
VL  - 209
IS  - 4
N2  - BACKGROUND: The role of angiointervention (ANGIO) in the management of high-grade liver injuries is not clear and there are concerns about increased complications. <br><br>METHODS: National Trauma Data Bank study, isolated grade IV and V blunt liver injuries. Patients with major associated intra-abdominal or extra-abdominal injuries were excluded. Logistic regression analysis was performed to identify independent predictors of mortality and complications. <br><br>RESULTS: Six thousand four hundred two patients met the criteria for inclusion. Laparotomy was performed in 32% of the patients and nonoperative management in 68%. Overall, 11% of the patients underwent ANGIO. Patients in the ANGIO group were significantly more likely to be older than 55 years than non-ANGIO patients and more likely to have Injury Severity Scores greater than 25. After stepwise logistic regression, ANGIO was an independent predictor of survival (P <.001). In the group of patients managed operatively, it was independently associated with a lower mortality (P <.001). Similarly, in the nonoperative group, it was independently associated with a lower mortality (5.4% vs 9.5%, P =.008). ANGIO was associated with increased systemic complications. <br><br>CONCLUSIONS: ANGIO in blunt, severe liver injuries is associated with reduced mortality and increased complications, in both operative and nonoperative management.<p />  <p>Language: en</p>
LA  - en
SN  - 0002-9610
UR  - http://dx.doi.org/10.1016/j.amjsurg.2014.06.024
ID  - ref1
ER  -