Evidence map›Paper›PMID 31062196›Full record

ArticleTechniques in coloproctology2019

Disparities in colostomy reversal after Hartmann's procedure for diverticulitis.

M C Turner, M D Talbott, C Reed, Z Sun, M L Cox, B Ezekian, K L Sherman, C R Mantyh, J Migaly

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Article in Techniques in coloproctology, 2019. 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
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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

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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.

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4 · The record

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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

9 authors.

M C TurnerDepartment of Surgery, Duke University Medical Center, Box 3443, Durham, NC, 27710, USA. megan.turner@duke.edu.
M D TalbottDuke University School of Medicine, Durham, NC, USA.
C ReedDepartment of Surgery, Duke University Medical Center, Box 3443, Durham, NC, 27710, USA.
Z SunDepartment of Surgery, Duke University Medical Center, Box 3443, Durham, NC, 27710, USA.
M L CoxDepartment of Surgery, Duke University Medical Center, Box 3443, Durham, NC, 27710, USA.
B EzekianDepartment of Surgery, Duke University Medical Center, Box 3443, Durham, NC, 27710, USA.
K L ShermanDepartment of Surgery, Duke University Medical Center, Box 3443, Durham, NC, 27710, USA.
C R MantyhDepartment of Surgery, Duke University Medical Center, Box 3443, Durham, NC, 27710, USA.
J MigalyDepartment of Surgery, Duke University Medical Center, Box 3443, Durham, NC, 27710, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHartmann's procedure for diverticulitis is a common procedure, with highly variable rates and timing of colostomy reversal. The aim of this study was to evaluate the impact of race and insurance coverage on reversal within 2 years of Hartmann's procedure for diverticulitis.

methodsThe Healthcare Cost and Utilization Project (HCUP) State Inpatient Database of five states (2007-2010) was queried for patients who had Hartmann's procedure in the setting of diverticulitis. Patients were grouped by race and insurance status, and multivariable adjustment was performed to evaluate rate and timing of colostomy takedown at 2 years.

resultsAmong 11,019 patients who had Hartmann's procedure for diverticulitis, 6900 (69%) patients had colostomy reversal by 2 years, with a median time to reversal of 19 weeks. Compared to white patients with private insurance, combinations of black race and non-private insurance significantly reduced likelihood of colostomy reversal at 2 years across all combinations. Black patients without insurance had the lowest likelihood of reversal at 2 years (OR 0.27, 95% CI 0.14-0.51, p < 0.001). For patients who had colostomy reversal within 2 years, black patients without insurance had a significant delay in time to reversal (11 weeks, 95% CI 6-16, p < 0.001) compared to white patients with private insurance, and delays persisted across all other groups.

conclusionsBlack patients and those without private insurance experienced significantly lower rates of, and delayed time to, colostomy reversal compared to white patients with private insurance. These disparities must be considered for allocation of resources in marginalized communities.

Indexed as

AgedColostomyDiverticulitis, ColonicFemaleHumansMaleMiddle AgedReoperationRisk FactorsTime FactorsUnited StatesColostomyDiverticulitisEthnic groupsHartmann’s procedureHealthHealthcare disparitiesInsuranceMedically uninsuredPopulation groups

Identifiers

PMID31062196

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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.