Elevated liver enzymes following polytraumatic injury

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Elevated liver enzymes following polytraumatic
injury

• Aaron Fox, MD James B. Sanderlin, MD Shane
  McNamee, MD Jasmohan S. Bajaj, MD William
  Carne, PhD David X. Cifu, MD

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• Aim
• Describe and examine factors associated with mild
  liver enzyme elevations in patients with
  traumatic brain injury (TBI).
• Relevance
• This information may help clinicians evaluate and
  manage individuals with TBI found to have
  elevated liver enzymes.

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Method

• Participants were servicemembers with TBI
  admitted to Hunter Holmes McGuire VA Medical
  Center Polytrauma Rehabilitation Center.
• January 2008 through December 2011.
• We retrospectively analyzed and categorized
  patients based on alanine aminotransferase (ALT)
  values (above or below 44 IU/L) on initial labs.

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Results

• Of 121 subjects, 59 (49) had ALT 44 IU/L.
• No significant differences between groups with
  regard to sex, military status, race, theater,
  TBI mechanism, severity of TBI, or concomitant
  injuries.
• Regardless of demographics, mechanism of injury,
  or extent of trauma, elevated liver enzymes were
  common.
• Enzymes typically returned to normal with
  conservative management.
• No specific etiology was defined in most cases.

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Conclusion

• Further analysis will be performed to determine
  most efficient way to monitor these patients so
  that unnecessary tests are avoided and medical
  expenses are minimized.