Evidence map›Paper›PMID 18981440›Full record

ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2008

Risk of incarceration of inguinal hernia among infants and young children awaiting elective surgery.

Mohammed Zamakhshary, Teresa To, Jun Guan, Jacob C Langer

Registry-linked trialOpen access · goldAbstract read
In one paragraph

Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03185637 (Paediatric Surgery Across Sub-Saharan Africa), which is not on this map. Cited by 35 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
35citing papers in PubMed, 1 pooled it
3.7field-weighted citation impact, top 7% 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.

NCT03185637 completednot on this mapstarted 2016, after this paper: background citation

Paediatric Surgery Across Sub-Saharan Africa: A Multi-Centre Prospective Cohort Study

Typeobservational_patient_registrySponsorKing's College LondonRan2016 to 2017Enrolled1,407ConditionsGastroschisis, Anorectal Malformation, Appendicitis, IntussusceptionArmsVarious interventions for each of the conditions.
3 · Its place in the literature

Who cites it

35 citing papers in PubMed, 1 synthesis or guideline pooled it, 111 citations in OpenAlex.

  1. Risk of incarceration in children with inguinal hernia: a systematic review.Hernia : the journal of hernias and abdominal wall surgery · 2019
    Pooled it
  2. Sutureless versus conventional open herniotomy in children with unilateral inguinal hernia.Hernia : the journal of hernias and abdominal wall surgery · 2026
    Trial
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 2 countries.

Mohammed ZamakhsharyDivision of General Surgery, The Hospital for Sick Children, Toronto, ON.
Teresa To
Jun Guan
Jacob C Langer
Hospital for Sick Children · CAKing Abdulaziz Medical City · SAKing Abdullah International Medical Research Center · SA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe determined the rate of incarceration of inguinal hernia among infants and young children waiting for elective surgery and examined the relation to wait times. We also explored the relation between wait times and the use of emergency department services before surgery.

methodsWe used linked data from administrative databases to identify infants and children less than 2 years of age who underwent surgical repair of an inguinal hernia between Apr. 1, 2002, and Mr. 31, 2004. We determined the rate of hernia incarceration during the wait for surgery and stratified the risk by patient age and sex. We used logistic regression analysis to examine factors associated with hernia incarceration and wait times.

resultsA total of 1065 infants and children less than 2 years old underwent surgical repair of an inguinal hernia during the study period. The median wait time was 35 days (interquartile range 17-77 days). Within 30 days after diagnosis, 126 (11.8%) of the patients had at least 1 emergency department visit; 23.8% of them presented with hernia incarceration. The overall rate of hernia incarceration was 11.9%. The rate was 5.2% with a wait time of up to 14 days (median time from diagnosis to first emergency department visit), as compared with 10.1% with a wait time of up to 35 days (median wait time to surgery) (p < 0.001). Factors associated with an increased risk of incarcerated hernia were age less than 1 year (odds ratio [OR] 2.07, 95% confidence interval [CI] 1.32-3.23), female sex (OR 1.75, 95% CI 1.04-2.93) and emergency department visits (1 visit, OR 2.73, 95% 1.65-4.50; > or = 2 visits, OR 3.77, 95% CI 1.89-7.43). Children less than 1 year old who waited longer than 14 days had a significant 2-fold risk of incarcerated hernia (OR 1.92, 95% CI 1.11-3.32).

interpretationA wait time for surgery of more than 14 days was associated with a doubling of the risk of hernia incarceration among infants and young children with inguinal hernia. Our data support a recommendation that inguinal hernias in this patient population be repaired within 14 days after diagnosis.

Indexed as

Elective Surgical ProceduresWaiting ListsAge FactorsChild, PreschoolDatabases as TopicEmergency Service, HospitalFemaleHernia, InguinalHumansInfantLogistic ModelsMaleOntarioRisk AssessmentSex Factors

Identifiers

PMID18981440
PMCPMC2572665
OpenAlexW2108669188

What OpenQuestion holds

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Registered trials

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.