Value of AST/ALT Ratio in Pediatric Liver Trauma

This study was aimed to determine the utility of aspartate aminotransferase and alanine aminotransferase ratio (AST/ALT ratio) in first 48 hours of injury, in children with liver trauma. The study was conducted in a prospective observational series of children younger than 15 years who had sustained blunt abdominal trauma. Children who were at risk of intra-abdominal trauma, were examined by physicians at Emergency Department of the Hospital and underwent standardized laboratory testing. From January 2004 to January 2008, 104 children presenting to the Emergency Department of General Hospital "Georgios Gennimatas" of Thessaloniki, for suspected physical abuse were prospectively entered in the study. All the children underwent complete history taking, physical examination and various laboratory investigations like white blood cell/hematocrit/platelets, aspartate aminotransferase, alanine aminotransferase, amylase and urinalysis. 104 children suffered intra-abdominal injuries and 20 had liver trauma. Transaminasemia correlated with liver injury when AST>200, ALT>150 and AST/ALT ratio >1. AST/ALT ratio can be used as a predictor for diagnosis of liver trauma and as a marker for response in nonoperative treatment-resuscitation.