Introduction Severe burns are devastating injuries affecting multiple organ systems. Little is
known about the influence on the hepatic system and its physiology. This systematic
review aimed to assess the current state of research on morphologic liver damage and
its markers following burns.
Methods Adhering to PRISMA guidelines, a search was conducted in Pubmed, Web of Science and
Cochrane databases. No publication date restrictions were applied. Publications were
limited to English, German and Spanish language. Outcomes included serum levels of
transaminases, fatty infiltration and necrosis. Weighted individual study estimates
were used to calculate pooled transaminase levels and necrosis/fatty infiltration
rates using a random-effects approach. Risk ratios or Odds ratios (ORs) and 95% confidence
intervals (CIs) were used to describe pooled estimates for risk factors.
Results The literature search retrieved 2548 hits, of which 59 studies were included into
qualitative synthesis, and finally ten studies were included into meta-analysis. Studies
were divided into those reporting autopsies and those reporting changes of serum transaminase
levels. The majority of liver autopsies showed fatty infiltration 82%(95% CI 39%-97%)
or necrosis of the liver 18%(95% CI 13%-24%).
Discussion Heterogeneity in studies on hepatic functional damage following severe burns was
high. Few were well-designed and published in recent years. Many studies were included
because of insufficient numerical data. Many patients deceasing from burns show fatty
infiltration or necrosis of hepatic tissue. Transaminases were elevated during the
first days after burn. Further research on how severe burns affect the hepatic function
and outcome, especially long-term, is necessary.
