Predictive value of liver transaminases levels in abdominal trauma.

INTRODUCTION: We aimed to evaluate whether hepatic transaminase levels could predict the presence and severity of liver injury following abdominal trauma.

METHODS: We performed a retrospective analysis of 75 surgically treated patients and 21 non-surgically treated patients with liver injury who were managed between 2004 and 2012. We retrieved demographic, laboratory, radiologic, and intraoperative data, as well as surgical procedures and the outcome from the patients' medical records. We compared the findings between patients divided into 2 groups according to the severity of liver injury: group 1, including patients with Grade 1 or 2 liver injuries; and group 2, including patients with grade 3 to 5 liver injury.

RESULTS: There were 87 (90.6%) males and 9 (9.4%) females. The mean age was 34 years (range, 17-90 years). The overall mortality rate was 14.6% (n = 14). The injury was blunt in 83 patients (86.5%) and penetrating in 13 patients (13.5%). There were multiple traumas in 60 patients (62.5%). Overall, 43 patients (44.8%) had a total of 61 coexisting intraabdominal injuries. The circulating aspartate aminotransferase, alanine aminotransferase, and lactate dehydrogenase (LDH) levels were significantly higher in group 2 than in group 1.

CONCLUSIONS: In patients with abdominal trauma, abnormal hepatic transaminase and LDH levels are associated with liver injury. Alanine aminotransferase ≤76 U/L, aspartate aminotransferase <130 U/L, and LDH ≤410 U/L are predictive of low-grade liver injury, and patients with serum liver levels below these levels can be managed conservatively.