@article{ref1,
title="Gunshot wound versus blunt liver injuries: different liver-related complications and outcomes",
journal="European journal of trauma and emergency surgery",
year="2022",
author="Fu, Yong and Lewis, Meghan R. and Mitchao, Delbrynth P. and Benjamin, Elizabeth R. and Wong, Monica and Demetriades, Demetrios",
volume="ePub",
number="ePub",
pages="ePub-ePub",
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. <br><br>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. <br><br>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. <br><br>CONCLUSION: GSW mechanism to the liver is associated with a higher incidence of liver-related complications than blunt force injury.<p /> <p>Language: en</p>",
language="en",
issn="1863-9933",
doi="10.1007/s00068-022-02096-6",
url="http://dx.doi.org/10.1007/s00068-022-02096-6"
}