Prognosis of trauma patients with liver injury who underwent observation after emergency department evaluation: a single trauma center retrospective study

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Careggi University Hospital Trauma Team: Marco Albanesi, Giovanni Alemanno, Lina Bartolini, Stefano Bianco, Elisabetta Cangioli, Pietro De Biase, Simona Di Valvasone, Roberto Federico, Andrea Franci, Gianluca Frezzetti, Francesca Innocenti, Fabio Mazzoni, Rita Piovelli, Paolo Prosperi, Massimo Sangiovanni, Alessandra Valletta, Gabriele Viviani. The prognosis of liver trauma patients not requiring immediate interventions remains unclear. This study aimed to evaluate the clinical outcomes of patients who suffered liver injuries and underwent a period of observation in the Emergency Department (ED). A retrospective single-center observational study was conducted in patients with liver trauma presenting to the ED between 2018-2024. Liver injuries were classified according to the American Association for the Surgery of Trauma (AAST) score. The outcome was the proportion of patients who died because of liver injuries or required surgical/endovascular liver procedures. A total of 120 patients were included. None of these patients died of complications related to their liver injury, while five died from other causes. Among the 101/120 (84%) patients with AAST I-III, one patient (AAST III) required liver-related interventions. On the other hand, among the 19/120 (16%) patients with AAST IV-V, 7/19 (37%) underwent liver interventions. Patients with isolated mild liver trauma (AAST I-II) might benefit from early discharge, while those with severe injuries (AAST IV-V) require monitoring and ready access to interventional radiology.

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