Role of Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST) in Diagnosing Liver Injury in Blunt Abdominal Trauma (BAT) Patients in The Emergency Department

Abstract

Objective: To evaluate the role of the liver enzymes ALT and AST in aiding the diagnosis and severity of liver injury in blunt abdominal trauma patients (BAT) presenting to the emergency department.

Study Design: Quasi-experimental study.

Place and Duration of Study: Accident and Emergency Department of Pak-Emirates Military Hospital, Rawalpindi, Pakistan, from May to Dec 2022.

Methodology: Blunt abdominal trauma (BAT) patients were included in the study. Urgent blood samples were sent with values for Hb, WBC, ALT, and AST recorded subsequently. The primary outcome studied was the relationship between ALT and AST to diagnosis and severity of liver injury, and mean ICU stay as the secondary parameter.

Results: A total of 200 patients (n=100 in patients with liver injury and n=100 in patients without liver injury) were analyzed. The mean age of patients in the liver injury group was 27.22±4.60 years as compared to 27.41±4.55 years for the non-liver injury group. Both groups were still comparable (p=0.793). The primary parameters of liver enzymes (ALT and AST) showed a marked increase in the liver injury group with mean values of ALT and AST 686.59±775.42 U/L and 647.27±654.36 U/L versus 77.56±43.08 U/L and 78.95±43.69 U/L in the non-liver injury group (p<0.001).

Conclusion:  The study concludes that liver enzymes ALT and AST show a progressive and marked increase during liver injury in blunt abdominal trauma patients and can be used as good adjunct markers for its diagnosis.