IS THE MANAGEMENT, COMPLICATIONS AND OUTCOMES OF PATIENTS WITH BLUNT AND PENETRATING LIVER INJURIES OF THE SAME AAST GRADE CATEGORIES COMPARABLE? A 4-YEAR RETROSPECTIVE ANALYSIS AT A TERTIARY CENTRE IN THE WESTERN CAPE, SOUTH AFRICA lucky.murangi@gmail.com

PW05-18

IS THE MANAGEMENT, COMPLICATIONS AND OUTCOMES OF PATIENTS WITH BLUNT AND PENETRATING LIVER INJURIES OF THE SAME AAST GRADE CATEGORIES COMPARABLE? A 4-YEAR RETROSPECTIVE ANALYSIS AT A TERTIARY CENTRE IN THE WESTERN CAPE, SOUTH AFRICA

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South Africa

Poster with Discussion

Traumatic injuries to the abdomen and involving solid organs such as the liver are common.The study aimed to determine whether blunt and penetrating injuries based on AAST grading (low grade: 1-3; high grade: 4-5) are comparable in terms of initial management and outcomes (morbidity, mortality, and complications).

A retrospective analytical review of traumatic liver injuries over 4 years (1 January 2019 to 31 December 2022), with inclusion criteria comprising adult patients (≥ 18 years) with traumatic liver injuries confirmed by an admission CT scan.

A total of 272 patients (median age: 32.3, males: 82.7%) were included, with 64.7% and 35.3% being categorized in the low and high AAST grades, respectively. A total of 159 (58.8%) penetrating and 111 (41.2%) blunt injuries were found. Male patients were significantly more in both the low and high grades notwithstanding the mechanism (p=0.022 and p=0.003 respectively). Patients with low grade injuries that sustained a blunt mechanism were significantly older (p=0.004) and had significantly lower RTS inter-quartile ranges (p<0.001). There was statistically significant uptake of NOM over surgical management for both low- and high-grade injuries (p< 0.001 and p= 0.003) respectively. The patients who had high grade injuries had significantly (p=0.023) more complications if the mechanism was penetrating as opposed to blunt.

Blunt and penetrating liver injuries based on AAST grading (low grade: 1-3; high grade: 4-5) are not entirely comparable in terms of demographics, physiological scores and some outcomes and hence the AAST grading might not be equally applicable holistically.