Evidence map›Paper›PMID 28457316›Full record

ArticleThe Journal of surgical research2017

Emergent laparotomy and temporary abdominal closure for the cirrhotic patient.

Tyler J Loftus, Janeen R Jordan, Chasen A Croft, R Stephen Smith, Philip A Efron, Frederick A Moore, Alicia M Mohr, Scott C Brakenridge

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of surgical research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.8field-weighted citation impact, top 23% 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, 4 citations in OpenAlex.

  1. Perioperative Evaluation and Management of Patients With Cirrhosis: Risk Assessment, Surgical Outcomes, and Future Directions.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2020
    Review
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

8 authors at 1 institution in 1 country.

Tyler J LoftusDepartment of Surgery, Sepsis and Critical Illness Research Center, University of Florida Health, Gainesville, Florida.
Janeen R JordanDepartment of Surgery, Sepsis and Critical Illness Research Center, University of Florida Health, Gainesville, Florida.
Chasen A CroftDepartment of Surgery, Sepsis and Critical Illness Research Center, University of Florida Health, Gainesville, Florida.
R Stephen SmithDepartment of Surgery, Sepsis and Critical Illness Research Center, University of Florida Health, Gainesville, Florida.
Philip A EfronDepartment of Surgery, Sepsis and Critical Illness Research Center, University of Florida Health, Gainesville, Florida.
Frederick A MooreDepartment of Surgery, Sepsis and Critical Illness Research Center, University of Florida Health, Gainesville, Florida.
Alicia M MohrDepartment of Surgery, Sepsis and Critical Illness Research Center, University of Florida Health, Gainesville, Florida.
Scott C BrakenridgeDepartment of Surgery, Sepsis and Critical Illness Research Center, University of Florida Health, Gainesville, Florida. Electronic address: Scott.Brakenridge@surgery.ufl.edu.
University of Florida Health · US

Funding

University of Florida Older Americans Independence Center (OAIC)P30AG028740 · NIA · UNIVERSITY OF FLORIDA · PI CHRISTIAAN LEEUWENBURGH · 2007 to 2026
$22.8M
PICS: A New Horizon for Surgical Critical CareP50GM111152 · NIGMS · UNIVERSITY OF FLORIDA · PI MOORE, FREDERICK A · 2014 to 2018
$10.7M
Molecular Biology in Burns and TraumaT32GM008721 · NIGMS · UNIVERSITY OF FLORIDA · PI Philip A Efron · 1999 to 2026
$5.0M
Chronic Stress and Anemia Recovery following Major TraumaR01GM105893 · NIGMS · UNIVERSITY OF FLORIDA · PI MOHR, ALICIA M · 2013 to 2021
$3.5M
Hematopoietic Stem Cell Dysfunction in the Elderly after Severe InjuryR01GM113945 · NIGMS · UNIVERSITY OF FLORIDA · PI EFRON, PHILIP A · 2015 to 2019
$1.6M
NIA NIH HHS P30 AG028740NIGMS NIH HHS P50 GM111152NIGMS NIH HHS R01 GM105893NIGMS NIH HHS R01 GM113945NIGMS NIH HHS T32 GM008721
6 · The paper itself

Abstract

backgroundTemporary abdominal closure (TAC) may be performed for cirrhotic patients undergoing emergent laparotomy. The effects of cirrhosis on physiologic parameters, resuscitation requirements, and outcomes following TAC are unknown. We hypothesized that cirrhotic TAC patients would have different resuscitation requirements and worse outcomes than noncirrhotic patients.

methodsWe performed a 3-year retrospective cohort analysis of 231 patients managed with TAC following emergent laparotomy for sepsis, trauma, or abdominal compartment syndrome. All patients were initially managed with negative pressure wound therapy (NPWT) TAC with intention for planned relaparotomy and sequential abdominal closure attempts at 24- to 48-h intervals.

resultsAt presentation, cirrhotic patients had higher incidence of acidosis (33% versus 17%) and coagulopathy (87% versus 54%) than noncirrhotic patients. Forty-eight hours after presentation, cirrhotic patients had a persistently higher incidence of coagulopathy (77% versus 44%) despite receiving more fresh frozen plasma (10.8 units versus 4.4 units). Cirrhotic patients had higher NPWT output (4427 mL versus 2375 mL) and developed higher vasopressor infusion rates (57% versus 29%). Cirrhotic patients had fewer intensive care unit-free days (2.3 versus 7.6 days) and higher rates of multiple organ failure (64% versus 34%), in-hospital mortality (67% versus 21%), and long-term mortality (80% versus 34%) than noncirrhotic patients.

conclusionsCirrhotic patients managed with TAC are susceptible to early acidosis, persistent coagulopathy, large NPWT fluid losses, prolonged vasopressor requirements, multiple organ failure, and early mortality. Future research should seek to determine whether TAC provides an advantage over primary fascial closure for cirrhotic patients undergoing emergency laparotomy.

Indexed as

Abdominal Wound Closure TechniquesLaparotomyNegative-Pressure Wound TherapyAdolescentAdultAgedAged, 80 and overEmergenciesFemaleFollow-Up StudiesHumansIntra-Abdominal HypertensionLiver CirrhosisMaleMiddle AgedRetrospective StudiesAscitesCirrhosisDamage control surgeryLaparotomyOpen abdomenTemporary abdominal closure

Identifiers

PMID28457316
PMCPMC5507175
OpenAlexW2554686220

What OpenQuestion holds

Textmetadata
LicenceTDM
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.