Evidence map›Paper›PMID 37843596›Full record

ArticleCVIR endovascular2023

Transarterial interventions in civilian gunshot wound injury: experience from a level-1 trauma center.

Qian Yu, Alex Lionberg, Kylie Zane, Ethan Ungchusri, Jonathan Du, Karan Nijhawan, Austin Clarey, Rakesh Navuluri, Osman Ahmed, Priya Prakash and 2 more

Open access · goldAbstract read
In one paragraph

Article in CVIR endovascular, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.6field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 1 institution in 1 country.

Qian YuDepartment of Radiology, University of Chicago Medical Center, 5841 S Maryland Ave, Chicago, IL, 60637, USA. qian.yu@uchicagomedicine.org.ORCID http://orcid.org/0000-0001-9774-9226
Alex LionbergDepartment of Radiology, University of Chicago Medical Center, 5841 S Maryland Ave, Chicago, IL, 60637, USA.
Kylie ZaneDepartment of Radiology, University of Chicago Medical Center, 5841 S Maryland Ave, Chicago, IL, 60637, USA.
Ethan UngchusriDepartment of Radiology, University of Chicago Medical Center, 5841 S Maryland Ave, Chicago, IL, 60637, USA.
Jonathan DuDepartment of Radiology, University of Chicago Medical Center, 5841 S Maryland Ave, Chicago, IL, 60637, USA.
Karan NijhawanDepartment of Radiology, University of Chicago Medical Center, 5841 S Maryland Ave, Chicago, IL, 60637, USA.
Austin ClareyDepartment of Radiology, University of Chicago Medical Center, 5841 S Maryland Ave, Chicago, IL, 60637, USA.
Rakesh NavuluriDepartment of Radiology, University of Chicago Medical Center, 5841 S Maryland Ave, Chicago, IL, 60637, USA.
Osman AhmedDepartment of Radiology, University of Chicago Medical Center, 5841 S Maryland Ave, Chicago, IL, 60637, USA.
Priya PrakashDepartment of Surgery, University of Chicago Medical Center, Chicago, IL, 60637, USA.
Jeffrey LeefDepartment of Radiology, University of Chicago Medical Center, 5841 S Maryland Ave, Chicago, IL, 60637, USA.
Brian FunakiDepartment of Radiology, University of Chicago Medical Center, 5841 S Maryland Ave, Chicago, IL, 60637, USA.
University of Chicago Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo assess the effectiveness of trans-arterial vascular interventions in treatment of civilian gunshot wounds (GSW). MATERIALS AND

methodsA retrospective review was performed at a level-1 trauma center to include 46 consecutive adults admitted due to GSW related hemorrhage and treated with endovascular interventions from July 2018 to July 2022. Patient demographics and procedural metrics were retrieved. Primary outcomes of interest include technical success and in-hospital mortality. Factors of mortality were assessed using a logistic regression model.

resultsTwenty-one patients were brought to the endovascular suite directly (endovascular group) from the trauma bay and 25 patients after treatment in the operating room (OR group). The OR group had higher hemodynamic instability (48.0% vs 19.0%, p = 0.040), lower hemoglobin (12.9 vs 10.1, p = 0.001) and platelet counts (235.2 vs 155.1, p = 0.003), and worse Acute Physiology and Chronic Health Evaluation (APACHE) score (4.1 vs 10.2, p < 0.0001) at the time of initial presentation. Technical success was achieved in all 40 cases in which targeted embolization was attempted (100%). Empiric embolization was performed in 6/46 (13.0%) patients based on computed tomographic angiogram (CTA) and operative findings. Stent-grafts were placed in 3 patients for subclavian artery injuries. Availability of pre-intervention CTA was associated with shorter fluoroscopy time (19.8 ± 12.1 vs 30.7 ± 18.6 min, p = 0.030). A total of 41 patients were discharged in stable condition (89.1%). Hollow organ injury was associated with mortality (p = 0.039).

conclusionEndovascular embolization and stenting were effective in managing hemorrhage due to GSW in a carefully selected population. Hollow organ injury was a statistically significant predictor of mortality. Pre-intervention CTA enabled targeted, shorter and equally effective procedures.

Indexed as

EmbolizationGun-shot woundPenetrating traumaStent-graftTrauma

Identifiers

PMID37843596
PMCPMC10579195
OpenAlexW4387661573

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.