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Factors affecting the outcome of liver trauma patients with non-operative management in the high care unit of Dr. Soetomo General Hospital Indonesia

  • Dyandri Yogi Astranto ,
  • Edwin Danardono ,
  • Iskandar Ali ,


Link of Video Abstract:


Background: The liver is the organ that experiences the most trauma when abdominal trauma occurs. Nonoperative management is the primary choice in patients with hepatic trauma with stable hemodynamics and no signs of peritonitis. Various factors that can affect outcomes

Methods: This study is a cross-sectional design using medical record data. The study sample was all patients with liver trauma with nonoperative management who met the inclusion and exclusion criteria.  The outcomes assessed were mortality and length of patient hospitalization. Data were analyzed using SPSS version 26.0 for Windows.

Results: Over 2 years, 42 patients with liver trauma were treated for nonoperative management. Most patients were male (76.2%) with the age of < 30 years (54.8%). Motorcycle accidents were the most common mechanism (83.3%), with most experiencing grade 4 liver trauma (33.3%). Of the 42 patients, 36 patients (85.7%) were accompanied by trauma to other organs. One mortality was obtained from a total of 42 patients aged ≥ 60 years, grade 5, and accompanied by comorbidities. There was a significant association between age, liver rupture grade, and comorbidity injuries and mortality in patients (p = 0.001; p = 0.01; p = 0.0001).  From the outcome of the length of hospitalization, there is a relationship that tends to be significant between the presence of comorbidity trauma and the length of hospitalization (p = 0.061)

Conclusion: Mortality in liver trauma patients with nonoperative management was influenced by age, liver rupture grade, and accompanying injuries. Meanwhile, the length of hospitalization is only affected by comorbidities.


  1. Saviano A, Ojetti V, Zanza C, Franceschi F, Longhitano Y, Martuscelli E, et al. Liver Trauma: Management in the Emergency Setting and Medico-Legal Implications. Diagnostics (Basel, Switzerland). 2022;12(6):1456.
  2. Chai Y, Lee J, Heo S, Lee Y, Lee Y, Jo Y, et al. Traumatic Liver Injury: Factors Associated with Mortality. Korean J Crit Care Med. 2014;29(4):320-327.
  3. Ahmed M, Mostafa H, Aly M. Different Modalities of Management of Liver Trauma (Operative and Nonoperative). Egypt J Hosp Med. 2019;75(4):2684–2689.
  4. García IC, Villalba JS, Iovino D, Franchi C, Iori V, Pettinato G, et al. Liver Trauma: Until When We Have to Delay Surgery? A Review. Life (Basel, Switzerland). 2022;12(5):694.
  5. Moore EE, Cogbill TH, Jurkovich GJ, Shackford SR, Malangoni MA, Champion HR. Organ injury scaling: spleen and liver (1994 revision). J Trauma. 1995;38(3):323–324.
  6. Gorman E, Bukur M, Frangos S, DiMaggio C, Kozar R, Klein M, et al. Increasing age is associated with worse outcomes in elderly patients with severe liver injury. Am J Surg. 2020;220(5):1308–1311.
  7. Lin HL, Lee KT, Chen CW, Kuo LC, Lin YK, Cheng YC, et al. Management of motorcycle accident-related blunt hepatic injury-a different strategy. Am J Emerg Med. 2010;28(2):177–182.
  8. Ghnnam WM, Almasry HN, Ghanem MAEF. Non-operative management of blunt liver trauma in a level II trauma hospital in Saudi Arabia. Int J Crit Illn Inj Sci. 2013;3(2):118–123.
  9. Tarchouli M, Elabsi M, Njoumi N, Essarghini M, Echarrab M, Chkoff MR. Liver trauma: What is current management? Hepatobiliary Pancreat Dis Int. 2018;17(1):39–44.
  10. Barrie J, Jamdar S, Iniguez MF, Bouamra O, Jenks T, Lecky F, et al. Improved outcomes for hepatic trauma in England and Wales over a decade of trauma and hepatobiliary surgery centralisation. Eur J trauma Emerg Surg Off Publ Eur Trauma Soc. 2018;44(1):63–70.
  11. Konig T, Aylwin C, Walsh M, Hutchins R. Modern management of liver trauma. Inj Extra. 2007;4(38):117.
  12. Dharma BDA, Mulyantari NK, Prabawa IPY. Analisis korelasi kadar serum prokalsitonin dengan jumlah leukosit pada penderita dengan kecurigaan sepsis di RSUP Sanglah, Bali, Indonesia. Intisari Sains Medis. 2020;11(1):179-182.
  13. Rau CS, Wu SC, Kuo PJ, Chen YC, Chien PC, Hsieh HY, et al. Polytrauma Defined by the New Berlin Definition: A Validation Test Based on Propensity-Score Matching Approach. Int J Environ Res Public Health. 2017;14(9):1045.

How to Cite

Astranto, D. Y., Danardono, E., & Ali, I. (2023). Factors affecting the outcome of liver trauma patients with non-operative management in the high care unit of Dr. Soetomo General Hospital Indonesia. Bali Medical Journal, 13(1), 265–269.




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