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Erschienen in: Wiener klinische Wochenschrift 23-24/2015

01.12.2015 | original article

Is it possible to use transaminases for deciding on surgical or non-operative treatment for blunt liver trauma?

verfasst von: MD Bulent Koca, Kagan Karabulut, Gokhan Selcuk Ozbalci, Ayfer Kamali Polat, Ismail Alper Tarim, Bahadir Bulent Gungor, Kenan Erzurumlu

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 23-24/2015

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Summary

Background

We aimed to research the relation of transaminase levels in blunt liver trauma (BLT) with the intensity of the trauma and the use of transaminase levels for deciding on surgical or non-operative treatment.

Methods

In all, 44 patients with BLT diagnosed by computerized tomography (CT) were involved in this retrospective study. By testing the correlation of the transaminase levels and the grade of liver injury with receiver operator characteristics (ROC), area under the curve (AUC) was calculated; besides, the sensitivity, specificity, and cut-off values of transaminases were calculated separately for the grades. Moreover, same method was repeated for the surgically and non-operatively treated patients. Cut-off value was assessed for surgical and non-operative treatments. The efficiency of transaminases in deciding non-operative treatment was compared with that of other methods using ROC test applied on focused abdominal sonography in trauma (FAST), hemodynamic instability, blood replacement rate, aspartate aminotransferase (AST), and alanine aminotransferase (ALT).

Results

It was observed that the AUC, sensitivity, and specificity increased correspondingly with the grade rise of transaminase levels in BLT. In the selection of non-operative treatment/surgery, following values have been confirmed: AUC for AST: 0.851 (sensitivity: 86 %, specificity: 73 %, cut-off value: 498 U/L), AUC for ALT: 0.880 (sensitivity: 86 %, specificity: 81 %, cut-off value: 498 U/L), AUC for replacement: 0.948 (sensitivity: 86 %, specificity: 94 %), AUC for hemodynamic instability: 0.902 (sensitivity: 86 %, specificity: 94 %), and AUC for FAST: 0.642 (sensitivity: 57 %, specificity: 75 %).

Conclusions

It was found that in BLT, transaminases can predict the injury rating with higher accuracy as the grade rises, and they outrival FAST in terms of determining the need for laparotomy.
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Metadaten
Titel
Is it possible to use transaminases for deciding on surgical or non-operative treatment for blunt liver trauma?
verfasst von
MD Bulent Koca
Kagan Karabulut
Gokhan Selcuk Ozbalci
Ayfer Kamali Polat
Ismail Alper Tarim
Bahadir Bulent Gungor
Kenan Erzurumlu
Publikationsdatum
01.12.2015
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 23-24/2015
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-015-0708-8