Journal of Rehabilitation Research & Development (JRRD)

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Volume 51 Number 6, 2014
   Pages 869 — 874

Abstract — Elevated liver enzymes following polytraumatic injury

Aaron Fox, MD;1* James B. Sanderlin, MD;2 Shane McNamee, MD;2 Jasmohan S. Bajaj, MD;3 William Carne, PhD;2 David X. Cifu, MD2

Departments of 1Primary Care, 2Physical Medicine and Rehabilitation, and 3Gastroenterology/Hepatology, Hunter Holmes McGuire Department of Veterans Affairs Medical Center, Richmond, VA

Abstract — This retrospective cohort study examined the prevalence and potential risk factors for elevated liver enzymes in patients following traumatic brain injury (TBI). The participants were servicemembers with TBI admitted to the Polytrauma Rehabilitation Center (PRC) at the Hunter Holmes McGuire Department of Veterans Affairs Medical Center in Richmond, Virginia, from January 2008 through December 2011. The PRC had 207 patients during this time period, 121 of whom had a liver panel within 30 d of injury. Patients were retrospectively analyzed and placed into one of two categories based on alanine aminotransferase (ALT) values. Of the 121 subjects, 59 (49%) had an ALT of 44 IU/L or greater on their initial set of laboratories. These subjects were compared with those with an ALT of 43 IU/L or less using chi square analysis. There were no significant differences between the two 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 in patients admitted to the rehabilitation unit following TBI. For the majority of these patients, enzymes returned to normal with conservative management. In most cases, no specific etiology was ever defined. Further analysis will be performed to determine the most efficient way to monitor these patients so that unnecessary tests are avoided and medical expenses are minimized.

Key words: blast injuries, brain injury, drug-induced liver injuries, liver enzyme elevations, liver function tests, polytraumatic injury, rehabilitation, TBI, trauma severity indices, Veteran.

View HTML ¦ View PDF ¦ Contents Vol. 51, No.6

This article and any supplementary material should be cited as follows:
Fox A, Sanderlin JB, McNamee S, Bajaj JS, Carne W, Cifu DX. Elevated liver enzymes following polytraumatic injury. J Rehabil Res Dev. 2014;51(6):869–74.

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Last Reviewed or Updated  Tuesday, October 14, 2014 2:01 PM

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