Evaluation of liver function tests in screening for intra-abdominal injuries

Area of Science:

• Trauma surgery
• Emergency medicine
• Clinical biochemistry

Background:

• Blunt trauma often leads to intra-abdominal injuries.
• Early detection of intra-abdominal injury is crucial for patient outcomes.
• The diagnostic utility of liver enzymes in blunt trauma is not fully established.

Purpose of the Study:

• To evaluate the effectiveness of serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT) in predicting intra-abdominal injury following blunt trauma.
• To establish thresholds for these enzymes that may indicate the need for advanced imaging.

Main Methods:

• A descriptive review of 309 adult blunt trauma admissions at a Level I trauma center.
• Consecutive patients admitted to the trauma service were included.
• Serum SGOT and SGPT levels were measured upon initial evaluation and during hospitalization, with all intra-abdominal injury evaluations recorded.

Main Results:

• Patients with SGOT/SGPT levels exceeding 130 IU/L showed significantly higher rates of intra-abdominal injury (52%) compared to those with levels below 130 IU/L (8%).
• All 18 patients with confirmed liver injuries had elevated SGOT/SGPT levels above 130 IU/L.
• Higher enzyme elevations correlated more strongly with the presence and severity of liver injury.

Conclusions:

• Elevated SGOT and SGPT levels serve as valuable markers for intra-abdominal injury in blunt trauma.
• SGOT/SGPT levels greater than 130 IU/L are indicative of potential intra-abdominal injury, suggesting the need for abdominal computed tomography (CT) scans.
• Levels below 130 IU/L are less likely to be associated with significant liver injury.