Predictive value of serum biochemical indicators combined with imaging scores for prognosis of traumatic liver rupture

doi:10.4240/wjgs.v18.i3.113773

Advanced Search

BPG is committed to discovery and dissemination of knowledge

Home / Archive / Volume 18, Issue 3

This Article

Peer-Review Report of This Article

CrossCheck and Google Search of This Article

Academic Rules and Norms of This Article

Citation of this article

Corresponding Author of This Article

Research Domain of This Article

Article-Type of This Article

Open-Access Policy of This Article

Times Cited Counts in Google of This Article

Number of Hits and Downloads for This Article

Total Article Views (72)

All Articles published online

The chart showing PDF series, HTML series, Figures (1-4) series, Tables (1-7) series.

Item

Count

PDF

HTML

Figures (1-4)

Tables (1-7)

Sum=20

Publishing Process of This Article

The chart showing Browse series, Download series.

Item

Count

Browse

Download

Sum=47

Mar 27, 2026 (publication date) through Mar 31, 2026

Times Cited of This Article

Times Cited (0)

Journal Information of This Article

Publication Name

World Journal of Gastrointestinal Surgery

ISSN

1948-9366

Publisher of This Article

Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Gastrointest Surg. Mar 27, 2026; 18(3): 113773
Published online Mar 27, 2026. doi: 10.4240/wjgs.v18.i3.113773

Table 1 Comparison of baseline characteristics between two groups, n (%)

Variable	Good prognosis group (n = 142)	Poor prognosis group (n = 44)	Statistical value	P value
Demographic characteristics
Age (years), mean ± SD	40.2 ± 14.8	48.5 ± 17.2	t = 3.15	0.002
Male	87 (61.3)	31 (70.5)	χ² = 1.25	0.264
BMI (kg/m²), mean ± SD	23.4 ± 3.2	24.1 ± 3.8	t = 1.12	0.264
Trauma mechanism
Traffic accident	78 (54.9)	28 (63.6)	χ² = 4.83	0.185
Fall from height	35 (24.6)	12 (27.3)	-	-
Heavy object impact	21 (14.8)	3 (6.8)	-	-
Others	8 (5.6)	1 (2.3)	-	-
Past medical history
Hypertension	23 (16.2)	12 (27.3)	χ² = 2.58	0.108
Diabetes	11 (7.7)	6 (13.6)	χ² = 1.42	0.233
Heart disease	8 (5.6)	4 (9.1)	χ² = 0.72	0.397
Other diseases	15 (10.6)	8 (18.2)	χ² = 1.86	0.172
Vital signs
Systolic BP (mmHg), mean ± SD	128.4 ± 18.3	108.2 ± 22.1	t = 5.98	< 0.001
Diastolic BP (mmHg), mean ± SD	78.5 ± 12.6	68.3 ± 15.2	t = 4.35	< 0.001
Heart rate (beats/minute), mean ± SD	88.7 ± 16.2	106.3 ± 21.4	t = 5.72	< 0.001
Respiratory rate (breaths/minute), mean ± SD	19.2 ± 3.4	22.8 ± 4.7	t = 5.21	< 0.001
Body temperature (°C), mean ± SD	36.8 ± 0.6	36.4 ± 0.8	t = 3.42	0.001
Consciousness and injury scores, mean ± SD
GCS score	14.2 ± 1.8	11.8 ± 2.7	t = 6.35	< 0.001
ISS score	12.4 ± 4.3	18.7 ± 6.2	t = 7.12	< 0.001

BMI: Body mass index; GCS: Glasgow Coma Scale; ISS: Injury Severity Score.

Full Size Table

Table 2 Comparison of serum biochemical indicators between two groups, mean ± SD

Indicator	Good prognosis group (n = 142)	Poor prognosis group (n = 44)	Statistical value	P value
Liver function indicators
ALT (U/L)	156.3 ± 89.2	312.7 ± 145.6	t = 7.65	< 0.001
AST (U/L)	168.4 ± 102.3	387.9 ± 178.4	t = 8.92	< 0.001
TBIL (μmol/L)	18.7 ± 8.4	34.2 ± 15.6	t = 7.23	< 0.001
DBIL (μmol/L)	7.2 ± 3.8	15.4 ± 8.2	t = 7.81	< 0.001
ALB (g/L)	38.6 ± 5.2	31.4 ± 6.8	t = 6.94	< 0.001
ALP (U/L)	89.3 ± 32.1	118.7 ± 45.3	t = 4.65	< 0.001
GGT (U/L)	45.8 ± 28.3	78.2 ± 41.6	t = 5.87	< 0.001
Coagulation function
PT (second)	12.8 ± 1.6	16.4 ± 3.2	t = 8.76	< 0.001
APTT (second)	28.4 ± 4.2	38.7 ± 8.1	t = 9.34	< 0.001
INR	1.08 ± 0.14	1.42 ± 0.28	t = 9.12	< 0.001
Inflammatory indicators
CRP (mg/L)	23.6 ± 18.4	67.8 ± 32.5	t = 9.87	< 0.001
PCT (ng/mL)	0.34 ± 0.28	1.28 ± 0.84	t = 8.45	< 0.001
WBC (× 10⁹/L)	11.2 ± 4.3	16.8 ± 6.7	t = 6.12	< 0.001
NEU% (%)	76.8 ± 9.2	85.4 ± 8.6	t = 5.38	< 0.001
Other indicators
Cr (μmol/L)	78.3 ± 18.2	112.6 ± 35.4	t = 7.23	< 0.001
BUN (mmol/L)	5.8 ± 2.1	9.4 ± 3.8	t = 6.89	< 0.001
LDH (U/L)	287.4 ± 84.6	468.3 ± 156.2	t = 8.76	< 0.001
CK (U/L)	345.2 ± 168.4	612.8 ± 284.7	t = 6.98	< 0.001

ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; TBIL: Total bilirubin; DBIL: Direct bilirubin; ALB: Albumin; ALP: Alkaline phosphatase; GGT: Gamma-glutamyl transferase; PT: Prothrombin time; APTT: Activated partial thromboplastin time; INR: International normalized ratio; CRP: C-reactive protein; PCT: Procalcitonin; WBC: White blood cell count; NEU: Neutrophil count; Cr: Creatinine; BUN: Blood urea nitrogen; LDH: Lactate dehydrogenase; CK: Creatine kinase.

Full Size Table

Table 3 Comparison of imaging scores between two groups, n (%)

Scoring system	Good prognosis group (n = 142)	Poor prognosis group (n = 44)	Statistical value	P value
WSES liver injury grading
Grade I	32 (22.5)	2 (4.5)	χ² = 28.47	< 0.001
Grade II	45 (31.7)	8 (18.2)
Grade III	38 (26.8)	12 (27.3)
Grade IV	21 (14.8)	15 (34.1)
Grade V	6 (4.2)	6 (13.6)
Grade VI	0 (0)	1 (2.3)
HIS score, mean ± SD	2.4 ± 1.1	3.8 ± 1.3	t = 6.98	< 0.001
LTSS score, mean ± SD
Liver injury extent score	1.2 ± 0.8	2.1 ± 0.9	t = 6.12	< 0.001
Hematoma size score	0.8 ± 0.7	1.4 ± 0.6	t = 5.23	< 0.001
Intraperitoneal bleeding score	1.1 ± 0.9	2.3 ± 0.8	t = 7.86	< 0.001
Active bleeding score	0.6 ± 0.7	1.5 ± 0.7	t = 7.41	< 0.001
LTSS total score	3.7 ± 2.1	7.3 ± 2.0	t = 9.87	< 0.001

WSES: World Society of Emergency Surgery; HIS: Hepatic Injury Scale; LTSS: Long-term services and supports.

Full Size Table

Table 4 Comparison of treatment plans between two groups, n (%)

Treatment plan	Good prognosis group (n = 142)	Poor prognosis group (n = 44)	χ²	P value
Conservative treatment	98 (69.0)	8 (18.2)	25.34	< 0.001
Surgical treatment	44 (31.0)	36 (81.8)	-	-
Liver repair	28 (19.7)	18 (40.9)	7.82	0.020
Partial hepatectomy	12 (8.5)	12 (27.3)	9.15	0.002
Hepatic artery embolization	4 (2.8)	6 (13.6)	6.87	0.009

Full Size Table

Table 5 Univariate analysis results for traumatic liver rupture prognosis (P < 0.05)

Variable	β	SE	Wald χ²	P value	OR value	95%CI
Baseline characteristics
Age	0.031	0.010	9.63	0.002	1.032	1.012-1.053
Vital signs
Systolic BP	-0.034	0.007	23.47	< 0.001	0.967	0.953-0.981
Diastolic BP	-0.047	0.014	11.29	0.001	0.954	0.928-0.981
Heart rate	0.056	0.009	38.45	< 0.001	1.058	1.038-1.078
Respiratory rate	0.211	0.044	23.12	< 0.001	1.236	1.134-1.347
Body temperature	-0.793	0.243	10.64	0.001	0.453	0.281-0.730
Scoring systems
GCS score	-0.361	0.082	19.41	< 0.001	0.698	0.593-0.821
ISS score	0.171	0.031	30.45	< 0.001	1.187	1.118-1.260
Serum biochemical indicators
ALT	0.008	0.002	16.84	< 0.001	1.008	1.005-1.011
AST	0.009	0.002	20.25	< 0.001	1.009	1.006-1.012
TBIL	0.093	0.017	29.78	< 0.001	1.098	1.061-1.136
DBIL	0.136	0.029	22.04	< 0.001	1.146	1.084-1.212
ALB	-0.181	0.037	24.01	< 0.001	0.834	0.777-0.896
ALP	0.018	0.005	12.96	< 0.001	1.018	1.008-1.028
GGT	0.025	0.005	25.00	< 0.001	1.025	1.014-1.036
PT	0.563	0.095	35.12	< 0.001	1.756	1.458-2.115
APTT	0.181	0.029	39.07	< 0.001	1.198	1.132-1.269
INR	2.847	0.624	20.84	< 0.001	17.238	5.081-58.484
CRP	0.051	0.008	40.64	< 0.001	1.052	1.036-1.068
PCT	2.109	0.493	18.31	< 0.001	8.245	3.142-21.654
WBC	0.145	0.031	21.84	< 0.001	1.156	1.087-1.229
NEU%	0.093	0.020	21.56	< 0.001	1.098	1.055-1.143
Cr	0.030	0.005	36.00	< 0.001	1.031	1.020-1.042
BUN	0.261	0.053	24.24	< 0.001	1.298	1.168-1.441
LDH	0.008	0.001	64.00	< 0.001	1.008	1.006-1.010
CK	0.003	0.0005	36.00	< 0.001	1.003	1.002-1.004
Imaging scores
HIS score	0.758	0.158	23.04	< 0.001	2.134	1.562-2.915
LTSS total score	0.629	0.084	56.07	< 0.001	1.876	1.587-2.215

OR: Odds ratio; CI: Confidence interval; BP: Blood pressure; GCS: Glasgow Coma Scale; ISS: Injury Severity Score; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; TBIL: Total bilirubin; DBIL: Direct bilirubin; ALB: Albumin; ALP: Alkaline phosphatase; GGT: Gamma-glutamyl transferase; PT: Prothrombin time; APTT: Activated partial thromboplastin time; INR: International normalized ratio; CRP: C-reactive protein; PCT: Procalcitonin; WBC: White blood cell count; NEU: Neutrophil count; Cr: Creatinine; BUN: Blood urea nitrogen; LDH: Lactate dehydrogenase; CK: Creatine kinase; HIS: Hepatic Injury Scale; LTSS: Long-term services and supports.

Full Size Table

Table 6 Multivariate logistic regression analysis for traumatic liver rupture prognosis

Variable	β	SE	Wald χ²	P value	OR value	95%CI
AST (U/L)	0.008	0.002	12.34	< 0.001	1.008	1.003-1.013
INR	2.534	0.687	13.62	< 0.001	12.596	3.281-48.347
CRP (mg/L)	0.023	0.006	14.78	< 0.001	1.023	1.011-1.036
GCS score	-0.394	0.128	9.48	0.002	0.675	0.525-0.867
LTSS total score	0.542	0.134	16.37	< 0.001	1.720	1.322-2.238
Constant	-2.463	1.234	3.98	0.046	0.085	-

OR: Odds ratio; CI: Confidence interval; AST: Aspartate aminotransferase; INR: International normalized ratio; CRP: C-reactive protein; GCS: Glasgow Coma Scale; LTSS: Long-term services and supports.

Full Size Table

Table 7 Comparison of predictive performance of various indicators and combined models

Predictive indicator/model	AUC	95%CI	Sensitivity (%)	Specificity (%)	Youden index
Single indicators
AST	0.798	0.728-0.868	75.0	78.2	0.532
INR	0.823	0.758-0.888	79.5	80.3	0.598
CRP	0.836	0.774-0.898	81.8	78.9	0.607
GCS score	0.742	0.665-0.819	72.7	71.8	0.445
LTSS total score	0.845	0.786-0.904	84.1	76.8	0.609
Combined models
Serum biochemical combined	0.887	0.836-0.938	84.1	85.2	0.693
Serum biochemical + imaging combined	0.923	0.881-0.965	86.4	91.5	0.779

AUC: Area under the curve; CI: Confidence interval; AST: Aspartate aminotransferase; INR: International normalized ratio; CRP: C-reactive protein; GCS: Glasgow Coma Scale; LTSS: Long-term services and supports.

Full Size Table

Citation: Yin H, Liu Y, Chen JT, Li Z, Pan Y, Zhu F. Predictive value of serum biochemical indicators combined with imaging scores for prognosis of traumatic liver rupture. World J Gastrointest Surg 2026; 18(3): 113773
URL: https://www.wjgnet.com/1948-9366/full/v18/i3/113773.htm
DOI: https://dx.doi.org/10.4240/wjgs.v18.i3.113773