Evidence map›Paper›PMID 27262479›Full record

ArticlePediatric surgery international2016

Quality improvement program reduces venous thromboembolism in infants and children with long-gap esophageal atresia (LGEA).

Daniel P Kelly, Sigrid Bairdain, David Zurakowski, Brenda Dodson, Kathy M Harney, Russell W Jennings, Cameron C Trenor

Abstract read
PubMed Publisher
In one paragraph

Article in Pediatric surgery international, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact, top 92% 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.

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

1 citing paper in PubMed, 1 synthesis or guideline pooled it, 2 citations in OpenAlex.

  1. Guideline
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

7 authors at 2 institutions in 1 country.

Daniel P KellyDivision of Medicine Critical Care, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, 02115, USA. Daniel.Kelly@childrens.harvard.edu.
Sigrid BairdainDepartment of Pediatric Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
David ZurakowskiDepartment of Pediatric Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
Brenda DodsonDepartment of Pharmacy, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
Kathy M HarneyDivision of Hematology and Oncology, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
Russell W JenningsDepartment of Pediatric Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
Cameron C TrenorDivision of Hematology and Oncology, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
Harvard University · USBoston Children's Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePatients with long-gap esophageal atresia (LGEA) treated with the Foker process are at increased risk of venous thromboembolism (VTE). An institutional quality improvement program to decrease VTE risk factor exposure and utilize prophylactic anticoagulation was implemented. We aim to evaluate the efficacy and safety of a VTE risk-reduction program in patients with LGEA.

methodsImplementation and evaluation of a VTE risk-reduction program in patients with LGEA from 2012 to 2015 was performed. Symptomatic VTE with radiographic confirmation were defined as events. Post-program characteristics were evaluated and compared to a historical cohort.

resultsSixty-seven patients were identified. Two developed VTE (7 %) post-program implementation; compared to 13/40 (33 %) VTE incidence in the historical cohort (p = 0.018). Baseline demographics were similar, including age, esophageal atresia type and gap length. Post-protocol patients had fewer paralysis episodes (p = 0.004), paralysis days (p = 0.003), central venous catheters (p = 0.003), thoracotomies (p < 0.001), ventilator hours (p = 0.02), and decreased hospital (p < 0.001) and ICU stay (p < 0.001). All patients in the VTE risk-reduction program were exposed to prophylactic anticoagulation. No bleeding complications and/or thrombosis-related mortality occurred.

conclusionVTE risk-reduction program implementation decreased symptomatic VTE incidence with associated decreases in ICU and hospital length of stay. Prophylactic anticoagulation can be utilized safely in a complicated pediatric surgical population.

Indexed as

Quality ImprovementAdolescentChildChild, PreschoolEsophageal AtresiaFemaleHumansIncidenceInfantInfant, NewbornMaleRisk FactorsUnited StatesVenous ThromboembolismLong gap esophageal atresiaSafetyThromboprophylaxisVenous thromboembolism

Identifiers

PMID27262479
OpenAlexW2410367032

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.