Table 4 Stratified meta-analyses and meta-regression of variables associated with failure of selective nonoperative management of abdominal gunshot wounds
Comparison | No. of studies | Pooled estimate of SNOM failure, % (95% CI) | I2 statistic, % | Meta-regression p value | |
|---|---|---|---|---|---|
Study temporality and setting | Prospective | 22 | 4.3 (2.7–6.0) | 24.4 | 0.27 |
Retrospective | 19 | 8.0 (2.8–13.3) | 95.6 | ||
Conducted in the USA | 29 | 8.1 (4.2–12.1) | 94.3 | NA | |
Conducted in South Africa | 8 | 4.7 (2.5–6.9) | 0 | 0.32* | |
Conducted in other countries | 4 | 7.0 (3.9–10.1) | 0 | 0.35* | |
Study patient injury patterns | Abdominal GSWs | 24 | 7.3 (3.0–11.5) | 95.1 | NA |
Liver GSWs | 5 | 6.6 (0.0–13.3) | 49.8 | 0.99†| |
Renal GSWs | 6 | 3.5 (0–7.3) | 0 | 0.39†| |
Back GSWs | 1 | 3.1 (0–6.5) | NA | 0.52†| |
Flank GSWs | 1 | 7.0 (3.9–10.1) | NA | 0.09†| |
Anterior abdomen GSWs | 1 | 13.2 (6.3–20.1) | NA | 0.51†| |
Right thoracoabdomen GSWs | 3 | 3.4 (0–7.0) | 0 | 0.45†| |
Reported SNOM practices | SNOM by attending surgeon | 5 | 2.1 (7.8–16.3) | 0 | 0.07 |
SNOM by surgical resident | 4 | 7.2 (3.9–10.5) | 89.5 | ||
Mandatory use of CT | 15 | 4.2 (1.9–6.5) | 33.5 | 0.08 | |
Selective use of CT | 19 | 8.3 (3.9–12.8) | 94.4 | ||