The Accuracy of liver enzymes as a predictor of Screening for liver injury in patients with blunt abdominal injury
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Abstract
Introduction: Elevated levels of AST and ALT are associated with liver injury resulting from blunt abdominal trauma. These biomarkers can aid in diagnosis and indicate the severity of the injury, leading to more effective and timely treatment.
Objective: To study the accuracy of liver enzyme levels in screening for liver injury in patients with blunt abdominal trauma
Methods: This retrospective study collected data from patients with blunt abdominal trauma who were treated in the emergency room and admitted to Chonburi Hospital between January 1, 2019, and July 31, 2021. A total of 162 patients were included. Statistical analysis was performed to assess the accuracy of liver enzyme levels using diagnostic tests. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio, negative likelihood ratio, and the area under the receiver operating characteristic curve (AUROC) were calculated. Logistic regression was used to identify predictors of liver injury.
Result: Among the 162 patients, 78 (48.14%) had liver injuries. The optimal cut-off point for AST was ≥185 U/L, with a sensitivity of 84.6% and specificity of 88.0% (AUROC 0.92). For ALT, the optimal cut-off was ≥127 U/L, with a sensitivity of 84.6% and specificity of 89.2% (AUROC 0.93). Multiple logistic regression analysis showed that female gender, age, AST ≥185 U/L, and ALT ≥127 U/L were significant predictors of liver injury in patients with blunt abdominal trauma.
Conclusion: AST ≥185 U/L and ALT ≥127 U/L can be used as cut-off values to help screen for potential liver injury in patients with blunt abdominal trauma. However, decisions regarding the need for a CT scan should not rely solely on AST and ALT levels, but also consider gender, age, and vital signs.
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