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European Journal of Trauma and Emergency Surgery

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17-09-2022 | Gunshot Wound | Original Article

Gunshot wound versus blunt liver injuries: different liver-related complications and outcomes

Authors: Yong Fu, Meghan R. Lewis, Delbrynth P. Mitchao, Elizabeth R. Benjamin, Monica Wong, Demetrios Demetriades

Published in: European Journal of Trauma and Emergency Surgery | Issue 1/2023

Abstract

Purpose

Severe hepatic injury due to gunshot (GSW) compared to blunt mechanism may have significantly different presentation, management, complications, and outcomes. The aim of this study was to identify the differences.

Methods

Retrospective single-center analysis June 1, 2015–June 30, 2020, included all patients with Grade III–V liver injuries due to GSW or blunt mechanism. Clinical characteristics, severity of injury, liver-related complications (rebleeding, necrosis/abscess, bile leak/biloma, pseudoaneurysm, acute liver failure) and overall outcomes (mortality, hospital length of stay, intensive care unit length of stay, and ventilatory days) were compared.

Results

Of 879 patients admitted with hepatic trauma, 347 sustained high-grade injury and were included: 81 (23.3%) due to GSW and 266 (76.7%) due to blunt force. A significantly larger proportion of patients with GSW were managed operatively (82.7 vs. 36.1%, p < 0.001). GSW was associated with significantly more liver-related complications (40.7% vs. 27.4%, p = 0.023), specifically liver necrosis/abscess (18.5% vs. 7.1%, p = 0.003) and bile leak/biloma (12.3% vs. 5.3%, p = 0.028). On subgroup analysis, in patients with grade III injury, the incidence of liver necrosis/abscess and bile leak/biloma remained significantly higher after GSW (13.9% vs. 3.1%, p = 0.008 and 11.1% vs. 2.5%, p = 0.018, respectively). In sub analysis of 88 patients with leading severe liver injuries, GSW had a significantly longer hospital length of stay, ICU length of stay, and ventilator days.

Conclusion

GSW mechanism to the liver is associated with a higher incidence of liver–related complications than blunt force injury.

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Title: Gunshot wound versus blunt liver injuries: different liver-related complications and outcomes
Authors: Yong Fu
Meghan R. Lewis
Delbrynth P. Mitchao
Elizabeth R. Benjamin
Monica Wong
Demetrios Demetriades
Publication date: 17-09-2022
Publisher: Springer Berlin Heidelberg
Keyword: Gunshot Wound
Published in: European Journal of Trauma and Emergency Surgery / Issue 1/2023
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-022-02096-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Gunshot wound versus blunt liver injuries: different liver-related complications and outcomes

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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