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

STUDY OBJECTIVES

To determine the utility of serum glutamic oxaloacetic transaminase (SGOT) and serum glutamic pyruvic transaminase (SGPT) in predicting intra-abdominal injury in blunt trauma patients.

DESIGN

Descriptive review of 309 blunt trauma admissions during study period.

SETTING

A 1,000-bed Level I trauma center in a major metropolitan area.

TYPE OF PARTICIPANTS

Consecutive adult blunt trauma admissions to the trauma service.

INTERVENTIONS

Serum levels of study enzymes were measured at initial evaluation and subsequent hospitalization. Results of all intra-abdominal evaluations were recorded.

MAIN RESULTS

Significantly greater numbers of patients with SGOT and/or SGPT elevated to more than 130 IU/L had associated intra-abdominal injuries as compared with patients with enzyme elevations of less than 130 IU/L (52% versus 8%). All 18 patients with liver injuries had one or both enzymes elevated to more than 130 IU/L. Higher enzyme levels were more frequently associated with liver injury.

CONCLUSIONS

Elevation of serum levels of the study enzymes is a marker for intra-abdominal injury. Levels in excess of 130 IU/L are relative indicators of abdominal computed tomography scan. Levels of less than 130 IU/L are unlikely to be associated with liver injury.