Evidence map›Paper›PMID 29313126›Full record

Observational studySurgical endoscopy2018

An observational study of the timing of surgery, use of laparoscopy and outcomes for acute cholecystitis in the USA and UK.

A C Murray, S Markar, H Mackenzie, O Baser, T Wiggins, A Askari, G Hanna, O Faiz, E Mayer, C Bicknell and 2 more

Abstract readMulticenter StudyObservational Study
PubMed Publisher
In one paragraph

Observational study in Surgical endoscopy, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 1 pooled it
–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

18 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  6. Observational
  7. Review
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  15. GI Surgical Emergencies: Scope and Burden of Disease.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2019
    Review
  16. Article
  17. Article
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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

12 authors.

A C MurrayDivision of Colorectal Surgery, New York Presbyterian Hospital/Columbia University Medical Center, Herbert Irving Pavilion, 161 Fort Washington Avenue, Floor: 8, New York, NY, 10032, USA.
S MarkarDepartment of Surgery and Cancer, Imperial College London, London, UK.
H MackenzieDepartment of Surgery and Cancer, Imperial College London, London, UK.
O BaserDepartment of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, USA.
T WigginsDepartment of Surgery and Cancer, Imperial College London, London, UK.
A AskariDepartment of Surgery and Cancer, Imperial College London, London, UK.
G HannaDepartment of Surgery and Cancer, Imperial College London, London, UK.
O FaizDepartment of Surgery and Cancer, Imperial College London, London, UK.
E MayerDepartment of Surgery and Cancer, Imperial College London, London, UK.
C BicknellDepartment of Surgery and Cancer, Imperial College London, London, UK.
A DarziDepartment of Surgery and Cancer, Imperial College London, London, UK.
R P KiranDivision of Colorectal Surgery, New York Presbyterian Hospital/Columbia University Medical Center, Herbert Irving Pavilion, 161 Fort Washington Avenue, Floor: 8, New York, NY, 10032, USA. rpk2118@cumc.columbia.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEvidence supports early laparoscopic cholecystectomy for acute cholecystitis. Differences in treatment patterns between the USA and UK, associated outcomes and resource utilization are not well understood.

methodsIn this retrospective, observational study using national administrative data, emergency patients admitted with acute cholecystitis were identified in England (Hospital Episode Statistics 1998-2012) and USA (National Inpatient Sample 1998-2011). Proportions of patients who underwent emergency cholecystectomy, utilization of laparoscopy and associated outcomes including length of stay (LOS) and complications were compared. The effect of delayed treatment on subsequent readmissions was evaluated for England.

resultsPatients with a diagnosis of acute cholecystitis totaled 1,191,331 in the USA vs. 288 907 in England. Emergency cholecystectomy was performed in 628,395 (52.7% USA) and 45,299 (15.7% England) over the time period. Laparoscopy was more common in the USA (82.8 vs. 37.9%; p < 0.001). Pre-treatment (1 vs. 2 days; p < 0.001) and total ( 4 vs. 7 days; p < 0.001) LOS was lower in the USA. Overall incidence of bile duct injury was higher in England than the USA (0.83 vs. 0.43%; p < 0.001), but was no different following laparoscopic surgery (0.1%). In England, 40.5% of patients without an immediate cholecystectomy were subsequently readmitted with cholecystitis. An additional 14.5% were admitted for other biliary complications, amounting to 2.7 readmissions per patient in the year following primary admission.

conclusionThis study highlights management practices for acute cholecystitis in the USA and England. Despite best evidence, index admission laparoscopic cholecystectomy is performed less in England, which significantly impacts subsequent healthcare utilization.

Indexed as

Cholecystectomy, LaparoscopicCholecystitis, AcuteEnglandFemaleHumansIncidenceLength of StayMaleMiddle AgedOperative TimePostoperative ComplicationsRetrospective StudiesTime-to-TreatmentUnited StatesAcute cholecystitisCholecystectomyInternational comparisonsLaparoscopyQuality

Identifiers

PMID29313126

What OpenQuestion holds

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Registered trials

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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.