CLINICAL ANALYSIS OF THE UTILITY OF REPEAT COMPUTED TOMOGRAPHIC SCAN BEFORE DISCHARGE IN BLUNT HEPATIC-INJURY

Objectives: Nonoperative management of hemodynamically stable blunt he patic injury has emerged as an acceptable and safe treatment. Surveill ance of this population's injuries is costly. As a prelude to establis hing practice guidelines, the utility of repeat computed tomographic ( CT) scans was investigated. Methods: A retrospective study was conduct ed on 243 hepatic injuries. The CT scans of 95 patients managed nonope ratively who did not have ongoing transfusion requirements were review ed and graded according to the American Association for the Surgery of Trauma (AAST) hepatic injury scale, Patients were grouped according t o injury grade, assigned to two subgroups (patients with one CT scan v ersus more than one CT scan) and compared with respect to several phys iologic and clinical variables. Results: Statistical analysis revealed no significant difference between subgroups with the same grade of in jury. No significant difference was demonstrated between subgroups' le ngth of stay. Conclusions: No patients failed nonoperative treatment o r succumbed to their injuries. Findings on repeat CT scan have not alt ered the decision to discharge the clinically stable patient having su ffered a grade III or lower liver injury.