Evidence map›Paper›PMID 31399949›Full record

Observational studySurgical endoscopy2020

Does the adoption of an emergency general surgery service model influence volume of cholecystectomies at a tertiary care center.

Gregory W Kirschen, Maria S Altieri, Suresh Yelika, Andrew T Bates, Jessica Schnur, Salvatore Docimo, Konstantinos Spaniolas, Chencan Zhu, Jie Yang, Mark Talamini and 2 more

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Surgical endoscopy, 2020. 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
–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

1 citing paper in PubMed.

  1. Tanaka score predicts surgical intensive care admission following abdominal wall reconstruction.Hernia : the journal of hernias and abdominal wall surgery · 2022
    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

12 authors.

Gregory W KirschenMedical Scientist Training Program (MSTP), Renaissance School of Medicine at Stony Brook University, Stony Brook, USA.
Maria S AltieriDepartment of Surgery, Renaissance School of Medicine at Stony Brook University, Stony Brook, USA.
Suresh YelikaDepartment of Surgery, Renaissance School of Medicine at Stony Brook University, Stony Brook, USA.
Andrew T BatesDepartment of Surgery, Renaissance School of Medicine at Stony Brook University, Stony Brook, USA.
Jessica SchnurDepartment of Surgery, Renaissance School of Medicine at Stony Brook University, Stony Brook, USA.
Salvatore DocimoDepartment of Surgery, Renaissance School of Medicine at Stony Brook University, Stony Brook, USA.
Konstantinos SpaniolasDepartment of Surgery, Renaissance School of Medicine at Stony Brook University, Stony Brook, USA.
Chencan ZhuGraduate Program in Applied Mathematics & Statistics, Stony Brook University, Stony Brook, USA.
Jie YangDepartment of Family, Population & Preventive Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, USA.
Mark TalaminiDepartment of Surgery, Renaissance School of Medicine at Stony Brook University, Stony Brook, USA.
Aurora D PryorDepartment of Surgery, Renaissance School of Medicine at Stony Brook University, Stony Brook, USA.
Samer SbayiDepartment of Surgery, Renaissance School of Medicine at Stony Brook University, Stony Brook, USA. Samer.sbayi@stonybrookmedicine.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe purpose of this study was to evaluate the rate of cholecystectomy before and after adoption of an emergency general surgery (EGS) model at our institution.

methodsA longitudinal, observational study was conducted prior to and following introduction of an EGS model at our institution. Using the New York SPARCS Administrative Database, all adult patients presenting to the emergency department with gallbladder-related emergencies were identified. The rates of laparoscopic and open cholecystectomies performed 3 years prior and 3 years following the adoption of the EGS model were examined. A multivariable logistic regression model was used to compare the incidence of cholecystectomy at initial ED visit at our institution pre- and post-EGS introduction as well as to those in the rest of the state as an external control group, while adjusting for potentially confounding factors.

resultsThere were 176,159 total ED visits of patients with gallbladder emergencies (154,743 excluding repeat presenters) in the studied period in NY State. Of these, 63,912 patients (41.3%) had a concurrent cholecystectomy in NY State. The rate of cholecystectomy at these institutions remained relatively steady from 38.8% from 2010 to 2013 and 38.6% from 2013 to 2016. At our institution, there were 2039 gallbladder emergencies, and of those 755 underwent cholecystectomy. At our institution, there was an increase from 28.21% 3 years prior to the adoption of the EGS model to 40.2% in the following 3 years (RR = 1.06, 95% CI 1.0164-1.1078, p = 0.0069).

conclusionThe initiation of the EGS model at a tertiary center was associated with a significant increase in the number of concurrent cholecystectomies from 28.21 to 40.2% over a 6-year period. This change was accompanied by an increase in the number of patient comorbidities and a lower insurance status.

Indexed as

AdultCholecystectomyComorbidityEmergency Service, HospitalEmergency TreatmentFemaleGallbladder DiseasesHumansIncidenceLogistic ModelsLongitudinal StudiesMaleMiddle AgedNew YorkRetrospective StudiesTertiary Care CentersAcute care modelQuality improvementSurgical emergencyWorkflow

Identifiers

PMID31399949

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.