caa a22 4500 606240322 CHVBK 20210128101307.0 cr unu---uuuuu 210128e20151201xx s 000 0 eng 10.1007/s00508-015-0708-8 doi (NATIONALLICENCE)springer-10.1007/s00508-015-0708-8 Is it possible to use transaminases for deciding on surgical or non-operative treatment for blunt liver trauma? [Elektronische Daten] [Bulent Koca, Kagan Karabulut, Gokhan Selcuk Ozbalci, Ayfer Kamali Polat, Ismail Alper Tarim, Bahadir Bulent Gungor, Kenan Erzurumlu] 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: 498U/L), AUC for ALT: 0.880 (sensitivity: 86%, specificity: 81%, cut-off value: 498U/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. Springer-Verlag Wien, 2015 Blunt liver trauma nationallicence Non-operative treatment nationallicence Transaminases nationallicence Koca Bulent Department of General Surgery, Korgan Stade Hospital, Ordu, Turkey aut Karabulut Kagan Department of General Surgery, Ondokuz Mayis University, Samsun, Turkey aut Ozbalci Gokhan Selcuk Department of General Surgery, Ondokuz Mayis University, Samsun, Turkey aut Polat Ayfer Kamali Department of General Surgery, Ondokuz Mayis University, Samsun, Turkey aut Tarim Ismail Alper Department of General Surgery, Ondokuz Mayis University, Samsun, Turkey aut Gungor Bahadir Bulent Department of General Surgery, Ondokuz Mayis University, Samsun, Turkey aut Erzurumlu Kenan Department of General Surgery, Ondokuz Mayis University, Samsun, Turkey aut Wiener klinische Wochenschrift Springer Vienna 127/23-24(2015-12-01), 954-958 0043-5325 127:23-24<954 2015 127 508 https://doi.org/10.1007/s00508-015-0708-8 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00508-015-0708-8 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Koca Bulent Department of General Surgery, Korgan Stade Hospital, Ordu, Turkey aut NATIONALLICENCE 700 1- Karabulut Kagan Department of General Surgery, Ondokuz Mayis University, Samsun, Turkey aut NATIONALLICENCE 700 1- Ozbalci Gokhan Selcuk Department of General Surgery, Ondokuz Mayis University, Samsun, Turkey aut NATIONALLICENCE 700 1- Polat Ayfer Kamali Department of General Surgery, Ondokuz Mayis University, Samsun, Turkey aut NATIONALLICENCE 700 1- Tarim Ismail Alper Department of General Surgery, Ondokuz Mayis University, Samsun, Turkey aut NATIONALLICENCE 700 1- Gungor Bahadir Bulent Department of General Surgery, Ondokuz Mayis University, Samsun, Turkey aut NATIONALLICENCE 700 1- Erzurumlu Kenan Department of General Surgery, Ondokuz Mayis University, Samsun, Turkey aut NATIONALLICENCE 773 0- Wiener klinische Wochenschrift Springer Vienna 127/23-24(2015-12-01), 954-958 0043-5325 127:23-24<954 2015 127 508