| Title |
Use of open and endovascular surgical techniques to manage vascular injuries in the trauma setting: A review of the American Association for the Surgery of Trauma PROspective Observational Vascular Injury Trial registry
|
|---|---|
| Published in |
Journal of Trauma and Acute Care Surgery, The, March 2018
|
| DOI | 10.1097/ta.0000000000001776 |
| Pubmed ID | |
| Authors |
Edwin R. Faulconer, Bernardino C. Branco, Melissa N. Loja, Kevin Grayson, James Sampson, Timothy C. Fabian, John B. Holcomb, Thomas Scalea, David Skarupa, Kenji Inaba, Nathaniel Poulin, Todd E. Rasmussen, Joseph J. Dubose |
| Abstract |
Vascular trauma data have been submitted to the American Association for the Surgery of Trauma PROspective Observational Vascular Injury Trial (PROOVIT) database since 2013. We present data to describe current use of endovascular surgery in vascular trauma. Registry data from March 2013 to December 2016 were reviewed. All trauma patients who had an injury to a named artery, except the forearm and lower leg, were included. Arteries were grouped into anatomic regions and by compressible and non-compressible region for analysis. This review focused on patients with non-compressible transection, partial transection, or flow limiting defect injuries. Bivariate and multivariate analyses were used to assess the relationships between study variables. 1143 patients from 22 institutions were included. Median age was 32 years (interquartile range IQR 23-48) and 76% (n=871) were male. Mechanisms of injury were 49% (n=561) blunt, 41% (n=464) penetrating, and 1.8% (n=21) of mixed aetiology. Gunshot wounds accounted for 73% (n=341) of all penetrating injuries. Endovascular techniques were used least often in limb trauma and most commonly in patients with blunt injuries to more than one region. Penetrating wounds to any region were preferentially treated with open surgery (74%, n=341/459). The most common indication for endovascular treatment was blunt non-compressible torso injuries (NCTI). These patients had higher injury severity scores and longer associated hospital stays, but required less packed red blood cells (PRBC), and had lower in hospital mortality than those treated with open surgery. On multivariate analysis, admission low hemoglobin concentration and abdominal injury were independent predictors of mortality. Our review of PROOVIT registry data demonstrates a high utilization of endovascular therapy among severely injured blunt trauma patients primarily with non-compressible torso hemorrhage. This is associated with decreased need for blood transfusion and improved survival despite longer length of stay. III, Therapeutic/care management. |
X Demographics
The data shown below were collected from the profiles of 35 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 12 | 34% |
| Canada | 3 | 9% |
| Venezuela, Bolivarian Republic of | 2 | 6% |
| Australia | 1 | 3% |
| Denmark | 1 | 3% |
| Guatemala | 1 | 3% |
| Brazil | 1 | 3% |
| Italy | 1 | 3% |
| Unknown | 13 | 37% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 18 | 51% |
| Practitioners (doctors, other healthcare professionals) | 10 | 29% |
| Scientists | 7 | 20% |
Mendeley readers
The data shown below were compiled from readership statistics for 43 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 43 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 8 | 19% |
| Researcher | 6 | 14% |
| Student > Postgraduate | 6 | 14% |
| Other | 3 | 7% |
| Student > Master | 3 | 7% |
| Other | 6 | 14% |
| Unknown | 11 | 26% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 24 | 56% |
| Nursing and Health Professions | 2 | 5% |
| Agricultural and Biological Sciences | 1 | 2% |
| Social Sciences | 1 | 2% |
| Computer Science | 1 | 2% |
| Other | 0 | 0% |
| Unknown | 14 | 33% |
Attention Score in Context
This research output has an Altmetric Attention Score of 21. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 21 March 2018.
All research outputs
#1,527,084
of 23,577,761 outputs
Outputs from Journal of Trauma and Acute Care Surgery, The
#424
of 4,104 outputs
Outputs of similar age
#35,237
of 332,399 outputs
Outputs of similar age from Journal of Trauma and Acute Care Surgery, The
#15
of 67 outputs
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So far Altmetric has tracked 4,104 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 11.3. This one has done well, scoring higher than 89% of its peers.
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We're also able to compare this research output to 67 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 77% of its contemporaries.