Evidence map›Paper›PMID 29876995›Full record

ArticleAlimentary pharmacology & therapeutics2018

Risk of post-operative surgical site infections after vedolizumab vs anti-tumour necrosis factor therapy: a propensity score matching analysis in inflammatory bowel disease.

K T Park, L Sceats, M Dehghan, A W Trickey, A Wren, J J Wong, R Bensen, B N Limketkai, K Keyashian, C Kin

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

Article in Alimentary pharmacology & therapeutics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 2 pooled it
3.1field-weighted citation impact, top 8% 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

13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 29 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
  5. Article
  6. Review
  7. Article
  8. Article
  9. Review
  10. Article
  11. Review
  12. Review
  13. 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

10 authors at 3 institutions in 1 country.

K T ParkDivision of Gastroenterology, Department of Pediatrics, Stanford Children's Inflammatory Bowel Disease Center, Stanford University School of Medicine, Palo Alto, CA, USA.ORCID 0000-0002-2133-3598
L SceatsDivision of Colorectal Surgery, Department of Surgery, Stanford-Surgery Policy Improvement Research and Education (S-SPIRE) Center, Stanford University School of Medicine, Palo Alto, CA, USA.
M DehghanDivision of Gastroenterology, Department of Pediatrics, Stanford Children's Inflammatory Bowel Disease Center, Stanford University School of Medicine, Palo Alto, CA, USA.
A W TrickeyDivision of Colorectal Surgery, Department of Surgery, Stanford-Surgery Policy Improvement Research and Education (S-SPIRE) Center, Stanford University School of Medicine, Palo Alto, CA, USA.
A WrenDivision of Gastroenterology, Department of Pediatrics, Stanford Children's Inflammatory Bowel Disease Center, Stanford University School of Medicine, Palo Alto, CA, USA.
J J WongHealth Services Research & Development, VA Palo Alto Health Care System, Palo Alto, CA, USA.
R BensenDivision of Gastroenterology, Department of Pediatrics, Stanford Children's Inflammatory Bowel Disease Center, Stanford University School of Medicine, Palo Alto, CA, USA.
B N LimketkaiDivision of Gastroenterology, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, USA.
K KeyashianDivision of Gastroenterology, Department of Medicine, Stanford University School of Medicine, Palo Alto, CA, USA.
C KinDivision of Colorectal Surgery, Department of Surgery, Stanford-Surgery Policy Improvement Research and Education (S-SPIRE) Center, Stanford University School of Medicine, Palo Alto, CA, USA.
Stanford University · USStanford Medicine · USVA Palo Alto Health Care System · US

Funding

Spectrum Stanford Center for clinical and Translational Research and EducationUL1TR001085 · NCATS · STANFORD UNIVERSITY · PI CULLEN, MARK RICHARD, GREENBERG, HARRY BERNARD · 2013 to 2017
$37.1M
Pharmaco-economics and Optimal Strategies of Biologics Use in Inflammatory BowelK08DK094868 · NIDDK · STANFORD UNIVERSITY · PI PARK, KT · 2012 to 2016
$769k
NCATS NIH HHS UL1 TR001085NIDDK NIH HHS K08 DK094868
6 · The paper itself

Abstract

backgroundPerioperative vedolizumab (VDZ) and anti-tumour necrosis factor (TNFi) therapies are implicated in causing post-operative complications in inflammatory bowel disease (IBD).

aimTo compare the risk of surgical site infections (SSIs) between VDZ- and TNFi-treated IBD patients in propensity-matched cohorts.

methodsThe Optum Research Database was used to identify IBD patients who received VDZ or TNFi within 30 days prior to abdominal surgery between January 2015 and December 2016. The date of IBD-related abdominal surgery was defined as the index date. SSIs were determined by ICD-9/10 and CPT codes related to superficial wound infections or deep organ space infections after surgery. Propensity score 1:1 matching established comparable cohorts based on VDZ or TNFi exposure before surgery based on evidence-based risk modifiers.

resultsThe propensity-matched sample included 186 patients who received pre-operative biologic therapy (VDZ, n = 94; TNFi, n = 92). VDZ and TNFi cohorts were similar based on age, gender, IBD type, concomitant immunomodulator exposure, chronic opioid or corticosteroid therapy, Charlson Comorbidity Index and malnutrition. VDZ patients were more likely to undergo an open bowel resection with ostomy. After propensity score matching, there was no significant difference in post-operative SSIs (TNFi 12.0% vs VDZ 14.9%, P = 0.56). Multivariable analysis indicated that malnutrition was the sole risk factor for developing SSI (OR 3.1, 95% CI 1.11-8.71) regardless of the type of biologic exposure.

conclusionIn the largest, risk-adjusted cohort analysis to date, perioperative exposure to VDZ therapy was not associated with a significantly higher risk of developing an SSI compared to TNFi therapy.

Indexed as

AdultAntibodies, Monoclonal, HumanizedAnti-Inflammatory AgentsCombined Modality TherapyDigestive System Surgical ProceduresFemaleHumansImmunotherapyInflammatory Bowel DiseasesLongitudinal StudiesMalePostoperative PeriodPropensity ScoreRetrospective StudiesRisk FactorsSurgical Wound InfectionAntibodies, Monoclonal, HumanizedAnti-Inflammatory AgentsTumor Necrosis Factor-alphavedolizumab

Identifiers

PMID29876995
PMCPMC6043399
OpenAlexW2805457320

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.