Discussion of: “Low-grade blunt hepatic injury and benefits of intensive care unit monitoring”

The premise for this research is extremely well founded in the contemporary climate of medicine with the ever present quest for efficiency, cost containment, and value while optimizing outcomes and preserving patient safety. A lot of times, the OR reports wouldn't say if the patient was going t...

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Bibliographic Details
Published in:The American journal of surgery 2017-12, Vol.214 (6), p.1193-1194
Main Authors: Perumean, Jeffrey C., Martinez, Marco, Neal, Rachel, Lee, James, Olajire-Aro, Taofeek, Imran, Jon B., Williams, Brian H., Phelan, Herb A.
Format: Article
Language:English
Subjects:
Blood transfusions
Containment
Hemorrhage
Humans
Injuries
Injury analysis
Injury prevention
Injury Severity Score
Intensive Care Units
Liver
Liver - injuries
Medical imaging
Medical records
Monitoring, Physiologic
Patients
Retrospective Studies
Trauma
Wounds, Nonpenetrating
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Summary:The premise for this research is extremely well founded in the contemporary climate of medicine with the ever present quest for efficiency, cost containment, and value while optimizing outcomes and preserving patient safety. A lot of times, the OR reports wouldn't say if the patient was going to the operating room because they failed conservative management, or they had continuing hemorrhage suspected from the suspected splenic injury, or at times it was just trauma to the abdomen going to the OR. [...]an analysis to isolated blunt hepatic injury, one of the limitations of just analyzing patients with isolated blunt hepatic injury is that I don't have enough patients to really make solid conclusions. [...]if you want to answer what to do with an isolated liver injury, I would say you do have enough numbers in this group to look at, and you have almost answered the question already, which is that almost all those patients with isolated liver injuries did very well. [...]I would say that liver injuries that need surgery usually require enough blunt force trauma, that they are going to injure something else if they are going to need something done, and if it's an isolated liver injury, my suspicion is that a lot of times those are minor injuries -- not all but a lot -- and probably could do without ICU admission.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2017.10.021