{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T18:13:18Z","timestamp":1788545598246,"version":"build-2803163510"},"reference-count":41,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:00:00Z","timestamp":1788480000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background: Blunt liver traumatic injuries are associated with high mortality and remain a significant challenge for modern healthcare systems. The aim of this study was to identify early clinical predictors of mortality in patients undergoing surgery for blunt liver injury. Material and Methods: A single-centre, retrospective observational study was conducted involving 27 adult patients who underwent surgery between 2013 and 2025 due to blunt liver injury (traffic accidents, falls from height). Clinical parameters such as GCS and shock index (SI) were correlated with the degree of injury according to the AAST OIS and WSES classifications and with the length of hospitalisation (LOS) using Spearman\u2019s rank correlation coefficient. The study was approved by the Bioethics Committee (resolution number: RNN\/86\/25\/KE). Results: Traffic accident victims predominated in the analysed group (81.5%). Deep consciousness disorders (GCS; \u03c1 = \u22120.65) were shown to be the strongest negative predictor of survival\u2014all deaths occurred in patients with a baseline GCS = 3. A strong positive correlation was also observed between the risk of death and the anatomical level of injury according to the AAST OIS (\u03c1 = 0.70) and shock assessed using the SI (\u03c1 = 0.50). Half of the patients who underwent surgery received packing (tamponade), while 51.8% underwent splenectomy. Conclusions: The GCS is the strongest independent clinical predictor of death in this group. Simple neurological and haemodynamic assessment is more useful in practice for quickly identifying critically ill patients than complex anatomical classifications such as AAST or WSES.<\/jats:p>","DOI":"10.3390\/jcm15176873","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T17:25:56Z","timestamp":1788542756000},"page":"6873","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic Factors of Mortality and Clinical Characteristics of Patients Surgically Treated for Blunt Liver Injury\u2014A Single-Center Experience"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-6492-9096","authenticated-orcid":false,"given":"Bart\u0142omiej","family":"Bia\u0142as","sequence":"first","affiliation":[{"name":"Ward of Endocrine, General and Oncological Surgery, Faculty of Medicine, Medical University of Lodz, M. Kopernik Provincial Multispecialist Centre for Oncology and Traumatology in \u0141\u00f3d\u017a, 91-513 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5584-1075","authenticated-orcid":false,"given":"Maciej","family":"Rybicki","sequence":"additional","affiliation":[{"name":"Ward of Endocrine, General and Oncological Surgery, Faculty of Medicine, Medical University of Lodz, M. Kopernik Provincial Multispecialist Centre for Oncology and Traumatology in \u0141\u00f3d\u017a, 91-513 Lodz, Poland"},{"name":"Plastic, Reconstructive and Aesthetic Surgery Clinic, Institute of Surgery, Medical University of Lodz, 90-419 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7151-7547","authenticated-orcid":false,"given":"Piotr Tomasz","family":"Arkuszewski","sequence":"additional","affiliation":[{"name":"Department of Biomedicine and Experimental Surgery, Faculty of Medicine, Medical University of Lodz, Narutowicza 60, 90-136 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2145-0708","authenticated-orcid":false,"given":"Micha\u0142","family":"Kusi\u0144ski","sequence":"additional","affiliation":[{"name":"Department of Endocrine, General and Oncological Surgery, Faculty of Medicine, Medical University of Lodz, M. Kopernik Provincial Multispecialist Centre for Oncology and Traumatology in \u0141\u00f3d\u017a, 91-513 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1097\/SLA.0000000000000600","article-title":"Increasing Trauma Deaths in the United States","volume":"260","author":"Rhee","year":"2014","journal-title":"Ann. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.1007\/s00268-018-04899-4","article-title":"Trends in the Nature and Management of Serious Abdominal Trauma","volume":"43","author":"Ferrah","year":"2019","journal-title":"World J. Surg."},{"key":"ref_3","first-page":"95","article-title":"The Epidemiology and Clinical Evaluation of Abdominal Trauma. An Analysis of a Multidisciplinary Trauma Registry","volume":"81","author":"Costa","year":"2010","journal-title":"Ann. Ital. Chir."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1016\/j.emc.2007.06.002","article-title":"Advances in Abdominal Trauma","volume":"25","author":"Isenhour","year":"2007","journal-title":"Emerg. Med. Clin. N. Am."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"153","DOI":"10.18203\/2349-2902.isj20160217","article-title":"A Study of Blunt Injury Abdomen in Patients Attending the Emergency Department in a Tertiary Hospital","volume":"3","author":"Yogish","year":"2016","journal-title":"Int. Surg. J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1136\/injuryprev-2015-041616","article-title":"The Global Burden of Injury: Incidence, Mortality, Disability-Adjusted Life Years and Time Trends from the Global Burden of Disease Study 2013","volume":"22","author":"Haagsma","year":"2016","journal-title":"Inj. Prev."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"3130","DOI":"10.1016\/j.injury.2022.06.020","article-title":"Epidemiology of Abdominal Trauma: An Age- and Sex-Adjusted Incidence Analysis with Mortality Patterns","volume":"53","author":"Tjosevik","year":"2022","journal-title":"Injury"},{"key":"ref_8","unstructured":"World Health Organization (2026, January 10). The Top 10 Causes of Death. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/the-top-10-causes-of-death."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1002\/bjs.6643","article-title":"Epidemiology of Major Trauma","volume":"96","year":"2009","journal-title":"Br. J. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2522","DOI":"10.1007\/s00268-009-0215-z","article-title":"Management of Liver Trauma","volume":"33","author":"Badger","year":"2009","journal-title":"World J. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2689","DOI":"10.1007\/s00268-017-4087-3","article-title":"Single Versus Multiple Solid Organ Injuries Following Blunt Abdominal Trauma","volume":"41","author":"Abdelrahman","year":"2017","journal-title":"World J. Surg."},{"key":"ref_12","first-page":"465","article-title":"Blunt Abdominal Trauma. A Review of 637 Patients","volume":"37","author":"Ball","year":"1996","journal-title":"J. Miss. State Med. Assoc."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/1749-7922-8-14","article-title":"Non Operative Management of Abdominal Trauma\u2014A 10 Years Review","volume":"8","author":"Raza","year":"2013","journal-title":"World J. Emerg. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1097\/TA.0000000000000942","article-title":"Outcomes and Complications of Angioembolization for Hepatic Trauma","volume":"80","author":"Green","year":"2016","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1590\/S0100-69912013000400011","article-title":"Trauma Hep\u00e1tico: Uma Experi\u00eancia de 21 Anos","volume":"40","author":"Zago","year":"2013","journal-title":"Rev. Col\u00e9gio Bras. Cir."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/s13017-020-00302-7","article-title":"Liver Trauma: WSES 2020 Guidelines","volume":"15","author":"Coccolini","year":"2020","journal-title":"World J. Emerg. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1590\/S0100-69912008000400004","article-title":"Trauma Hep\u00e1tico: Epidemiologia de Cinco Anos Em Um Servi\u00e7o de Emerg\u00eancia","volume":"35","author":"Stalhschmidt","year":"2008","journal-title":"Rev. Col\u00e9gio Bras. Cir."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1347","DOI":"10.1016\/j.injury.2012.01.003","article-title":"Predictive Factors of Morbidity and Mortality in Grade IV and V Liver Trauma Undergoing Perihepatic Packing: Single Institution 14 Years Experience at European Trauma Centre","volume":"43","author":"Catena","year":"2012","journal-title":"Injury"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1097\/00005373-199601000-00007","article-title":"Status of Nonoperative Management of Blunt Hepatic Injuries in 1995","volume":"40","author":"Pachter","year":"1996","journal-title":"J. Trauma Inj. Infect. Crit. Care"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1097\/00005373-200001000-00011","article-title":"Approach to the Management of Complex Hepatic Injuries","volume":"48","author":"Asensio","year":"2000","journal-title":"J. Trauma Inj. Infect. Crit. Care"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1097\/TA.0000000000002058","article-title":"AAST Patient Assessment Committee. Organ Injury Scaling 2018 Update: Spleen, Liver, and Kidney","volume":"85","author":"Kozar","year":"2018","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.injury.2006.08.064","article-title":"Predictors of Outcome in Patients Requiring Surgery for Liver Trauma","volume":"38","author":"Sikhondze","year":"2007","journal-title":"Injury"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"57","DOI":"10.30733\/std.2020.01398","article-title":"Our Experience of Nonoperative Management in Patients with Liver Injury Due to Multiple Blunt Trauma","volume":"1","author":"Vatansev","year":"2021","journal-title":"Selcuk. Med. J."},{"key":"ref_24","first-page":"68","article-title":"Analysis of Trauma Scoring System for Patients with Abdominal Trauma","volume":"29","author":"Jang","year":"2022","journal-title":"Turk. J. Trauma Emerg. Surg. TJTES"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1148\/rg.251045079","article-title":"CT in Blunt Liver Trauma","volume":"25","author":"Yoon","year":"2005","journal-title":"RadioGraphics"},{"key":"ref_26","first-page":"e20233424","article-title":"Experience of Non-Operative Management of Blunt Liver Trauma at Hospital Das Cl\u00ednicas de Uberl\u00e2ndia: 114 Cases","volume":"50","author":"Fernandes","year":"2023","journal-title":"Rev. Col\u00e9gio Bras. Cir."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/TA.0000000000004684","article-title":"Liver Injury: What You Need to Know","volume":"100","author":"Reed","year":"2026","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"30","DOI":"10.5604\/01.3001.0015.4548","article-title":"Location of Liver Lacerations Resulting from Deceleration Injuries and a Proposal for Their Classification","volume":"93","author":"Arkuszewski","year":"2021","journal-title":"Pol. J. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1097\/TA.0b013e3182395e68","article-title":"Experimental Multiscale Analysis of Liver Damage and Failure Process under Compression","volume":"72","author":"Conte","year":"2012","journal-title":"J. Trauma Acute Care Surg."},{"key":"ref_30","first-page":"39","article-title":"Patterns of Liver Injury after Fatal Blunt Trauma","volume":"134","author":"Hardy","year":"1972","journal-title":"Surg. Gynecol. Obstet."},{"key":"ref_31","unstructured":"Gennarelli, T.A., and Wodzin, E. (2008). The Abbreviated Injury Scale 2005: Update 2008, Association for the Advancement of Automotive Medicine (AAAM)."},{"key":"ref_32","first-page":"249","article-title":"Zur Aussagekraft des Injury-Severity-Score (ISS) [Value of the injury severity score (ISS)]","volume":"15","author":"Schneck","year":"1985","journal-title":"Aktuelle Traumatol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"S31","DOI":"10.4103\/sja.SJA_543_18","article-title":"The STROBE Guidelines","volume":"13","author":"Cuschieri","year":"2019","journal-title":"Saudi J. Anaesth."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1056\/NEJMra1109343","article-title":"Injuries","volume":"368","author":"Norton","year":"2013","journal-title":"N. Engl. J. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1055\/s-0041-1724014","article-title":"Hepatic Trauma Interventions","volume":"38","author":"Pillai","year":"2021","journal-title":"Semin. Interv. Radiol."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Arkuszewski, P., Pasieka, Z., \u015amigielski, J., and K\u0142osi\u0144ski, K. (2025). Transverse Rupture of Segment II (Couinaud) of the Left Hepatic Lobe in Deceleration Trauma: Morphological Characteristics and a Strategy for Intraoperative Detection. J. Clin. Med., 14.","DOI":"10.3390\/jcm14144889"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1007\/s00595-013-0515-7","article-title":"Liver Injury Following Blunt Abdominal Trauma: A New Mechanism-Driven Classification","volume":"44","author":"Slotta","year":"2014","journal-title":"Surg. Today"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1007\/s003300050433","article-title":"Blunt Abdominal Trauma in Adults: Role of CT in the Diagnosis and Management of Visceral Injuries","volume":"8","author":"Becker","year":"1998","journal-title":"Eur. Radiol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1195","DOI":"10.21037\/atm-20-4580","article-title":"Hepatic Trauma","volume":"9","author":"Roberts","year":"2021","journal-title":"Ann. Transl. Med."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1007\/s00270-007-9277-1","article-title":"Place of Arterial Embolization in Severe Blunt Hepatic Trauma: A Multidisciplinary Approach","volume":"31","author":"Monnin","year":"2008","journal-title":"Cardiovasc. Interv. Radiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e109","DOI":"10.1002\/bjs.9360","article-title":"Damage Control Surgery for Abdominal Emergencies","volume":"101","author":"Weber","year":"2014","journal-title":"J. Br. Surg."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/17\/6873\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T17:39:22Z","timestamp":1788543562000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/17\/6873"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,4]]},"references-count":41,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["jcm15176873"],"URL":"https:\/\/doi.org\/10.3390\/jcm15176873","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,4]]}}}