Contained Hepatic Vascular Injuries Following Liver Trauma

NCT06249646 | Completed

• 1 other identifier: 24Urgences01
• Study Type: observational
• Target: 318
• Locations: 1 country
• Sites: 1

Brief Summary

Background: For thirty years, a major shift in the management of liver trauma has been seen. Contained hepatic vascular injuries (CHVI), including pseudo aneurysms and arteriovenous fistula, are often feared due to their risk of secondary bleeding. Nonetheless, knowledge of CHVI is scarce and no guidelines on their management have been set. The investigators aimed to validate the risk factors of CHVI, identify associated morbidities, and establish a management protocol. Study Design: A retrospective study on 318 liver trauma from a level 1 trauma center over the last 15 years, comparing the presence or not of CHVI. Univarious and multivarious analyses were performed. A comparison of the management of CHVI was also performed.

Conditions

Hepatic Injury; Liver Injury; Pseudoaneurysm

Outcome Measures

Primary Outcomes (1)

• Identification of a % of CHVI on the initial or the follow-up Chest-Thorax scans.

  A junior and a senior radiologist reviewed all initial and follow-up CT scans, blinded from the diagnostic. Contained hepatic vascular injuries (CHVI) was defined as Hepatic Pseudoaneurysm (HPA) and/or arterio-venous fistula (AVF), under the American Association for Surgery of Trauma (AAST) organ injury scale (2018 revision) for liver trauma definition: a contained focal collection of vascular contrast which decreases in attenuation on delayed phase images on contrast-enhanced CT

  6 months

Secondary Outcomes (1)

• Investigate the management of CHVI following liver trauma.

  6 months

Eligibility Criteria

• Age: 15 Years+
• Sex: all
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Liver trauma was identified on post-injury imaging evaluation or operative exploration. Admission following the trauma could either be directly from the trauma location or be a transfer from another regional hospital. Upon admission, if the patient was stable or stabilized following intensive care management, a contrast full-body CT scan was performed. Non-operative management was the primary treatment when possible. If the patient was unstable, primary surgical management was required. Surgical management could include sole exploration, hemostatic techniques, hepatic packing, drainage, or hepatectomy. If the investigators performed a damage control laparotomy with perihepatic packing, a second surgery was performed for definitive treatment after 24-48 h. In such cases, a contrast full-body CT scan was performed after the surgery. If a CT scan was not performed in the first 24 hours, the patient was not included in this study.

You may qualify if:

• presence of liver trauma
• age above 15 years old
• a full contrast abdominal CT

Sponsors & Collaborators

• Centre Hospitalier Universitaire de Nice: lead

Study Sites (1)

CHU de Nice

Nice, Alpes Maritimes, 06000, France

Location

MeSH Terms

Conditions

Aneurysm, False

Condition Hierarchy (Ancestors)

Vascular Diseases; Cardiovascular Diseases

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 23, 2024
• First Posted: February 8, 2024
• Study Start: January 1, 2022
• Primary Completion: October 31, 2022
• Study Completion: March 31, 2023
• Last Updated: February 8, 2024

Record last verified: 2024-01

Data Sharing

• IPD Sharing: Will not share

Locations

FR (1)