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Cochrane Database of Systematic Reviews

Non-operative management versus operative management in high-grade blunt hepatic injury

Overview of attention for article published in Cochrane database of systematic reviews, August 2015
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Title
Non-operative management versus operative management in high-grade blunt hepatic injury
Published in
Cochrane database of systematic reviews, August 2015
DOI 10.1002/14651858.cd010989.pub2
Pubmed ID
Authors

Roberto Cirocchi, Stefano Trastulli, Eleonora Pressi, Eriberto Farinella, Stefano Avenia, Carlos Hernando Morales Uribe, Ana Maria Botero, Luis M Barrera

Abstract

Surgery used to be the treatment of choice in cases of blunt hepatic injury, but this approach gradually changed over the last two decades as increasing non-operative management (NOM) of splenic injury led to its use for hepatic injury. The improvement in critical care monitoring and computed tomographic scanning, as well as the more frequent use of interventional radiology techniques, has helped to bring about this change to non-operative management. Liver trauma ranges from a small capsular tear, without parenchymal laceration, to massive parenchymal injury with major hepatic vein/retrohepatic vena cava lesions. In 1994, the Organ Injury Scaling Committee of the American Association for the Surgery of Trauma (AAST) revised the Hepatic Injury Scale to have a range from grade I to VI. Minor injuries (grade I or II) are the most frequent liver injuries (80% to 90% of all cases); severe injuries are grade III-V lesions; grade VI lesions are frequently incompatible with survival. In the medical literature, the majority of patients who have undergone NOM have low-grade liver injuries. The safety of NOM in high-grade liver lesions, AAST grade IV and V, remains a subject of debate as a high incidence of liver and collateral extra-abdominal complications are still described. To assess the effects of non-operative management compared to operative management in high-grade (grade III-V) blunt hepatic injury. The search for studies was run on 14 April 2014. We searched the Cochrane Injuries Group's Specialised Register, The Cochrane Library, Ovid MEDLINE(R), Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily and Ovid OLDMEDLINE(R), Embase Classic+Embase (Ovid), PubMed, ISI WOS (SCI-EXPANDED, SSCI, CPCI-S & CPSI-SSH), clinical trials registries, conference proceedings, and we screened reference lists. All randomised trials that compare non-operative management versus operative management in high-grade blunt hepatic injury. Two authors independently applied the selection criteria to relevant study reports. We used standard methodological procedures as defined by the Cochrane Collaboration. We were unable to find any randomised controlled trials of non-operative management versus operative management in high-grade blunt hepatic injury. In order to further explore the preliminary findings provided by animal models and observational clinical studies that suggests there may be a beneficial effect of non-operative management versus operative management in high-grade blunt hepatic injury, large, high quality randomised trials are needed.

Twitter Demographics

The data shown below were collected from the profile of 1 tweeter who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 94 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 1%
Unknown 93 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 13 14%
Researcher 11 12%
Other 11 12%
Student > Postgraduate 10 11%
Student > Bachelor 10 11%
Other 22 23%
Unknown 17 18%
Readers by discipline Count As %
Medicine and Dentistry 46 49%
Nursing and Health Professions 10 11%
Psychology 6 6%
Pharmacology, Toxicology and Pharmaceutical Science 2 2%
Social Sciences 2 2%
Other 6 6%
Unknown 22 23%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. 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 03 September 2015.
All research outputs
#10,024,055
of 12,527,219 outputs
Outputs from Cochrane database of systematic reviews
#8,751
of 8,923 outputs
Outputs of similar age
#164,013
of 238,614 outputs
Outputs of similar age from Cochrane database of systematic reviews
#232
of 248 outputs
Altmetric has tracked 12,527,219 research outputs across all sources so far. This one is in the 11th percentile – i.e., 11% of other outputs scored the same or lower than it.
So far Altmetric has tracked 8,923 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 21.2. This one is in the 3rd percentile – i.e., 3% of its peers scored the same or lower than it.
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We're also able to compare this research output to 248 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.