Evidence map›Paper›PMID 28930037›Full record

ArticleCanadian journal of surgery. Journal canadien de chirurgie2017

Regional consolidation of orthopedic surgery: impacts on hip fracture surgery access and outcomes.

Sara A Kreindler, Lanette Siragusa, Eric Bohm, Wendy Rudnick, Colleen J Metge

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

Article in Canadian journal of surgery. Journal canadien de chirurgie, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.2field-weighted citation impact, top 19% 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

5 citing papers in PubMed, 9 citations in OpenAlex.

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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

5 authors at 2 institutions in 1 country.

Sara A KreindlerFrom the Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man. (Kreindler, Bohm, Metge); the George and Fay Yee Centre for Healthcare Innovation, University of Manitoba and Winnipeg Regional Health Authority, Winnipeg, Man. (Kreindler, Bohm, Metge); the College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man. (Siragusa); the Department of Surgery, University of Manitoba and Winnipeg Regional Health Authority, Winnipeg, Man. (Bohm); the Concordia Hip and Knee Institute, Winnipeg Regional Health Authority, Winnipeg, Man. (Bohm); and the St. Boniface Hospital, Winnipeg, Man. (Rudnick).
Lanette SiragusaFrom the Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man. (Kreindler, Bohm, Metge); the George and Fay Yee Centre for Healthcare Innovation, University of Manitoba and Winnipeg Regional Health Authority, Winnipeg, Man. (Kreindler, Bohm, Metge); the College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man. (Siragusa); the Department of Surgery, University of Manitoba and Winnipeg Regional Health Authority, Winnipeg, Man. (Bohm); the Concordia Hip and Knee Institute, Winnipeg Regional Health Authority, Winnipeg, Man. (Bohm); and the St. Boniface Hospital, Winnipeg, Man. (Rudnick).
Eric BohmFrom the Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man. (Kreindler, Bohm, Metge); the George and Fay Yee Centre for Healthcare Innovation, University of Manitoba and Winnipeg Regional Health Authority, Winnipeg, Man. (Kreindler, Bohm, Metge); the College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man. (Siragusa); the Department of Surgery, University of Manitoba and Winnipeg Regional Health Authority, Winnipeg, Man. (Bohm); the Concordia Hip and Knee Institute, Winnipeg Regional Health Authority, Winnipeg, Man. (Bohm); and the St. Boniface Hospital, Winnipeg, Man. (Rudnick).
Wendy RudnickFrom the Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man. (Kreindler, Bohm, Metge); the George and Fay Yee Centre for Healthcare Innovation, University of Manitoba and Winnipeg Regional Health Authority, Winnipeg, Man. (Kreindler, Bohm, Metge); the College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man. (Siragusa); the Department of Surgery, University of Manitoba and Winnipeg Regional Health Authority, Winnipeg, Man. (Bohm); the Concordia Hip and Knee Institute, Winnipeg Regional Health Authority, Winnipeg, Man. (Bohm); and the St. Boniface Hospital, Winnipeg, Man. (Rudnick).
Colleen J MetgeFrom the Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man. (Kreindler, Bohm, Metge); the George and Fay Yee Centre for Healthcare Innovation, University of Manitoba and Winnipeg Regional Health Authority, Winnipeg, Man. (Kreindler, Bohm, Metge); the College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man. (Siragusa); the Department of Surgery, University of Manitoba and Winnipeg Regional Health Authority, Winnipeg, Man. (Bohm); the Concordia Hip and Knee Institute, Winnipeg Regional Health Authority, Winnipeg, Man. (Bohm); and the St. Boniface Hospital, Winnipeg, Man. (Rudnick).
University of Manitoba · CAGeorge & Fay Yee Centre for Healthcare Innovation · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTimely access to orthopedic trauma surgery is essential for optimal outcomes. Regionalization of some types of surgery has shown positive effects on access, timeliness and outcomes. We investigated how the consolidation of orthopedic surgery in 1 Canadian health region affected patients requiring hip fracture surgery.

methodsWe retrieved administrative data on all regional emergency department visits for lower-extremity injury and all linked inpatient stays from January 2010 through March 2013, identifying 1885 hip-fracture surgeries. Statistical process control and interrupted time series analysis controlling for demographics and comorbidities were used to assess impacts on access (receipt of surgery within 48-h benchmark) and surgical outcomes (complications, in-hospital/30-d mortality, length of stay).

resultsThere was a significant increase in the proportion of patients receiving surgery within the benchmark. Complication rates did not change, but there appeared to be some decrease in mortality (significant at 6 mo). Length of stay increased at a hospital that experienced a major increase in patient volume, perhaps reflecting challenges associated with patient flow.

conclusionRegionalization appeared to improve the timeliness of surgery and may have reduced mortality. The specific features of the present consolidation (including pre-existing interhospital performance variation and the introduction of daytime slates at the referral hospital) should be considered when interpreting the findings.

Indexed as

Hospital MortalityEmergency Service, HospitalHealth Services AccessibilityHip FracturesHumansLength of StayManitobaOrthopedic ProceduresOutcome Assessment, Health CarePostoperative Complications

Identifiers

PMID28930037
PMCPMC5608585
OpenAlexW2760409272

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.