Assessing the utility of surveillance imaging in high-grade liver injury patients

The utility of surveillance imaging (SI) after high-grade liver injury is unclear. We studied SI's detection rate and its association with unplanned interventions, emergency department (ED) visits, and mortality.

Adult patients with American Association for the Surgery of Trauma (AAST) grade III-V liver injury (2018-2024) were categorized by follow-up imaging: surveillance imaging (SI, no clinical change), clinically-prompted imaging (CI), or none. Outcomes included unplanned intervention, liver-related ED visits, and mortality.

Among 252 patients, SI prompted intervention in 10 ​% of cases versus 31 ​% for CI. Unplanned interventions were more frequent after CI than SI (37 ​% vs. 18 ​%; p ​= ​0.018). ED visits were marginally lower after SI versus CI (30 ​% vs. 43 ​%; p ​= ​0.10). Mortality did not differ across groups.

SI identified complications in select patients and was associated with fewer unplanned interventions, marginally fewer ED visits, and no mortality difference compared to CI.