Evidence map›Paper›PMID 23921862›Full record

ArticleObstetrics and gynecology2013

Effectiveness of mesh compared with nonmesh sling surgery in Medicare beneficiaries.

Anne M Suskind, J Quentin Clemens, Rodney L Dunn, Yun Zhang, John T Stoffel, Brent K Hollenbeck

Abstract readComparative Study
In one paragraph

Article in Obstetrics and gynecology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
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

6 authors.

Anne M SuskindDow Division of Health Services Research and the Division of Neurology and Pelvic Reconstructive Surgery, Department of Urology, The University of Michigan, Ann Arbor, Michigan 48109-2800, USA.
J Quentin Clemens
Rodney L Dunn
Yun Zhang
John T Stoffel
Brent K Hollenbeck

Funding

Uro Translational Research and Clinical Research Training (UroTRACT)T32DK007782 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI WEI, JOHN T · 2000 to 2019
$2.9M
Ambulatory Surgery Centers and Medicare Expenditures for Outpatient ProceduresR01HS018726 · AHRQ · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HOLLENBECK, BRENT K. · 2010 to 2013
$1.8M
AHRQ HHS R01 HS018726AHRQ HHS R01 HS018726-01NIDDK NIH HHS T32 DK007782NIDDK NIH HHS T32 DK07782
6 · The paper itself

Abstract

objectiveTo assess the effectiveness of mesh compared with nonmesh slings placed in different surgical settings as measured by the frequency of complications within 1 year.

methodsWe performed a retrospective cohort study of Medicare beneficiaries undergoing sling surgery from 2006 to 2008 in hospital outpatient departments and hospital-based ambulatory surgery centers. Slings were identified and categorized according to the use of mesh by Healthcare Common Procedure Coding System codes and temporary "C" Healthcare Common Procedure Coding System codes. Patients were followed for 1 year after each procedure to identify complications. Logistic models were fit to assess relationships among sling type, surgical setting, and various complications.

resultsWe identified 6,698 Medicare beneficiaries who underwent mesh sling procedures and 445 Medicare beneficiaries who underwent nonmesh sling procedures. The overall frequency of complications was similar between the two groups at 69.8% and 72.6% in the mesh and nonmesh groups, respectively (P=.22). Infectious complications were the most common complication at 45.4% and 50.1% of the mesh and nonmesh groups, respectively (P=.06). Patients undergoing mesh procedures were less likely than patients undergoing nonmesh procedures to require management for bladder outlet obstruction (13.9% compared with 19.3%, adjusted odds ratio [OR] 0.66, 95% confidence interval [CI] 0.52-0.85) and were less likely to have a subsequent sling removal and revision or urethrolysis (2.7% compared with 4.7%, adjusted OR 0.56, 95% CI 0.35-0.89).

conclusionFrequencies of most complications were similar regardless of the use of mesh except for the management of bladder outlet obstruction. These results did not differ based on the surgical setting where the sling procedure was performed. LEVEL OF EVIDENCE: II.

Indexed as

AgedAged, 80 and overAmbulatory Surgical ProceduresFemaleHumansLogistic ModelsMedicareRetrospective StudiesSuburethral SlingsSurgical MeshUnited StatesUrinary Incontinence, Stress

Identifiers

PMID23921862
PMCPMC3750097

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