Accident-related hepatic trauma in a medical clinical center in eastern China: a cross-sectional study

Abstract Background The treatment of hepatic injury can be complex. Medical clinical centers are often the first line hospitals for the diagnosis and treatment of hepatic trauma in China. The aim of the study is to summarize the experience in the diagnosis and treatment of hepatic trauma in one medical clinical center in China. Methods This retrospective study included patients with hepatic trauma admitted between January 2002 and December 2019 at the Xishan People’s Hospital of Wuxi. The outcomes were cure rate and death within 14 days post-discharge. Results Among the 318 patients with hepatic trauma, 146 patients underwent surgical treatment, and 172 received conservative treatment; three patients were transferred to other hospitals for further treatment; 283 patients were cured, and 35 died. Severe hepatic trauma occurred in 74 patients, with a mortality rate of 31.1% and accounting for 65.7% of total mortality. American Association for the Surgery of Trauma (AAST) grading ≥ III (OR = 3.51, 95%CI: 1.32–9.37, P = 0.012) and multiple organ injury (OR = 7.51, 95%CI: 2.51–22.46, P < 0.001) were independently associated with death. Among patients with AAST grading ≥ III, surgery was an independent protective factor for death (OR = 0.08, 95%CI: 0.01–0.45, P = 0.004). Among patients with ASST ≥ III and who underwent surgery, age (OR = 5.29, 95%CI: 1.37–20.33, P = 0.015) and peri-hepatic packing (PHP) (OR = 5.54, 95%CI: 1.43–21.487, P = 0.013) were independently associated with death. Conclusions AAST grading ≥ III and multiple organ injury were independently associated with death. Among patients with AAST grading ≥ III, surgery was an independent protective factor for death. Among patients with ASST ≥ III and who underwent surgery, age and PHP were independently associated with death.

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Accident-related Hepatic Trauma in a Medical Clinical Center in Eastern China: A Cross-sectional Study

10.21203/rs.3.rs-97665/v1 ◽

2020 ◽

Author(s):

Zipeng Xu ◽

Weidong Hu ◽

Xu Shen ◽

Yanyan Gu ◽

Zhengxing Dai ◽

...

Keyword(s):

Protective Factor ◽

Eastern China ◽

Multiple Organ ◽

Diagnosis And Treatment ◽

Organ Injury ◽

Hepatic Trauma ◽

Post Discharge ◽

Cross Sectional ◽

Clinical Center ◽

Multiple Organ Injury

Abstract Background: The treatment of hepatic injury can be complicated. Medical clinical hospitals are often the first line hospitals for the diagnosis and treatment of hepatic trauma in China. This paper aimed to summarize the experience in the diagnosis and treatment of hepatic trauma in one medical clinical center in China. Methods: This retrospective study included patients with hepatic trauma admitted between January 2002 and December 2019 at the Xishan People’s Hospital of Wuxi. The outcomes were cure rate and death within 14 days post-discharge. Results: Among the 318 patients with hepatic trauma, 146 patients underwent surgical treatment, and 172 received conservative treatment; three patients were transferred to other hospitals for further treatment; 283 patients were cured, and 35 died. Severe hepatic trauma occurred in 74 patients, with a mortality rate of 31.1%, or 7.2% of all patients. American Association for the Surgery of Trauma (AAST) grading >III (OR=3.51, 95%CI: 1.32-9.37, P=0.012) and multiple organ injury (OR=7.51, 95%CI: 2.51-22.46, P<0.001) were independently associated with death. Among patients with AAST grading >III, surgery was an independent protective factor for death (OR=0.08, 95%CI: 0.01-0.45, P=0.004). Among patients with ASST >III and who underwent surgery, age (OR=5.29, 95%CI: 1.37-20.33, P=0.015) and PHP (OR=5.54, 95%CI: 1.43-21.487, P=0.013) were independently associated with death.Conclusions: AAST grading >III and multiple organ injury were independently associated with death. Among patients with AAST grading >III, surgery was an independent protective factor for death. Among patients with ASST >III and who underwent surgery, age and PHP were independently associated with death.

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The selective guanylate cyclase inhibitor ODQ reduces multiple organ injury in rodent models of Gram-positive and Gram-negative shock

Critical Care Medicine ◽

10.1097/00003246-200108000-00017 ◽

2001 ◽

Vol 29 (8) ◽

pp. 1599-1608 ◽

Cited By ~ 17

Author(s):

Kai Zacharowski ◽

Reinhard Berkels ◽

Antje Olbrich ◽

Prabal K. Chatterjee ◽

Salvatore Cuzzocrea ◽

...

Keyword(s):

Guanylate Cyclase ◽

Multiple Organ ◽

Organ Injury ◽

Rodent Models ◽

Gram Positive ◽

Gram Negative ◽

Multiple Organ Injury ◽

Negative Shock

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Effect Measure Modification and Confounding of Severe Head Injury Mortality by Age and Multiple Organ Injury Severity

Annals of Epidemiology ◽

10.1016/j.annepidem.2006.08.004 ◽

2007 ◽

Vol 17 (2) ◽

pp. 142-147 ◽

Cited By ~ 10

Author(s):

Shai Linn ◽

Leon Levi ◽

Peter D. Grunau ◽

Itzhak Zaidise ◽

Salman Zarka

Keyword(s):

Head Injury ◽

Severe Head Injury ◽

Injury Severity ◽

Multiple Organ ◽

Organ Injury ◽

Injury Mortality ◽

Effect Measure ◽

Effect Measure Modification ◽

Multiple Organ Injury

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Ubiquitin-Specific Protease 25 Aggravates Acute Pancreatitis and Acute Pancreatitis-Related Multiple Organ Injury by Destroying Tight Junctions Through Activation of The STAT3 Pathway

Frontiers in Cell and Developmental Biology ◽

10.3389/fcell.2021.806850 ◽

2022 ◽

Vol 9 ◽

Author(s):

Zhengru Liu ◽

Mingming Qi ◽

Shan Tian ◽

Qian Yang ◽

Jian Liu ◽

...

Keyword(s):

Acute Pancreatitis ◽

Tight Junctions ◽

Multiple Organ ◽

Organ Injury ◽

Pancreatic Acinar Cells ◽

Stat3 Pathway ◽

Specific Protease ◽

Ubiquitin Specific Protease ◽

Multiple Organ Injury

Ubiquitin-specific protease 25 (USP25) plays an important role in inflammation and immunity. However, the role of USP25 in acute pancreatitis (AP) is still unclear. To evaluate the role of USP25 in AP, we conducted research on clinical AP patients, USP25wild-type(WT)/USP25 knockout (USP25−/−) mice, and pancreatic acinar cells. Our results showed that serum USP25 concentration was higher in AP patients than in healthy controls and was positively correlated with disease severity. AP patients’ serum USP25 levels after treatment were significantly lower than that at the onset of AP. Moreover, USP25 expression was upregulated in cerulein-induced AP in mice, while USP25 deficiency attenuates AP and AP-related multiple organ injury. In vivo and in vitro studies showed that USP25 exacerbates AP by promoting the release of pro-inflammatory factors and destroying tight junctions of the pancreas. We showed that USP25 aggravates AP and AP-related multiple organ injury by activating the signal transducer and activator of transcription 3 (STAT3) pathway. Targeting the action of USP25 may present a potential therapeutic option for treating AP.

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