WHEN AGE MEETS IMPACT: EXPLORING HIGH-GRADE LIVER TRAUMA IN OLDER ADULTS krusso4@emory.edu

PW05-09

WHEN AGE MEETS IMPACT: EXPLORING HIGH-GRADE LIVER TRAUMA IN OLDER ADULTS

4

United States

Oral or Poster

The liver is one of the most frequently injured solid organs in trauma, yet data on managing these injuries in older adults remains limited. This population faces higher mortality and an increased risk of intra-abdominal injury from low-energy mechanisms, highlighting the need for further study. We aimed to investigate patients over age 65 with high-grade liver injuries (American Association for Surgery of Trauma [AAST] grades III-V) to characterize liver injury severity, management, and outcomes.

Retrospective cohort review was conducted of patients aged >65 with high-grade liver injuries (AAST grades III, IV, V) admitted to an urban Level 1 trauma center from January 1, 2016 to December 31, 2024.

Of the 213 patients, 67 (31.5%) sustained high-grade liver injuries. The median age was 72 (range, 65-97 years). Most injuries resulted from blunt mechanisms (n=59, 88%), with the remainder due to penetrating trauma (n=8, 12%). Among those requiring intervention, 8 (11.9%) underwent interventional radiology (IR) angiography, 12 (17.9%) underwent operative management, and 5 (7.5%) received both. Mortality among non-operative patients was 4.7% (2/42), compared to 24% (6/25) in those who underwent intervention.

In this cohort, blunt trauma was the predominant mechanism, and most were successfully managed non-operatively. While IR and operative interventions appear associated with higher mortality, overall mortality was lower than reported in prior studies. These findings emphasize the complexity of managing severe hepatic trauma in the elderly and need for further investigation on comorbidities and strategies to improve outcomes in this vulnerable population.