Evidence map›Paper›PMID 31801568›Full record

ArticleJournal of orthopaedic surgery and research2019

The effect of orthopaedic surgeons' and interventional radiologists' availability on the priority treatment sequence for hemodynamically unstable pelvic fractures: a survey of US Level I trauma centers.

S Jarvis, A Orlando, B Blondeau, K Banton, C Reynolds, G M Berg, N Patel, R Meinig, M Carrick, D Bar-Or

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Article in Journal of orthopaedic surgery and research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

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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

2 citing papers in PubMed.

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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

10 authors.

S JarvisClinical Epidemiologist, ION Research, 383 Corona St. #319, Denver, CO, 80218, USA.
A OrlandoClinical Epidemiologist, ION Research, 383 Corona St. #319, Denver, CO, 80218, USA.
B BlondeauResearch Medical Center, 2316 East Meyer Blvd., Kansas City, MO, 64132, USA.
K BantonSwedish Medical Center, 501 E Hampden Ave., Englewood, CO, 80113, USA.
C ReynoldsSwedish Medical Center, 501 E Hampden Ave., Englewood, CO, 80113, USA.
G M BergWesley Medical Center, 550 N. Hillside St., Wichita, KS, 67214, USA.
N PatelOrthopaedic Trauma Surgeon, St. Anthony's Hospital, 11600 West 2nd Place, Lakewood, CO, 80228, USA.
R MeinigOrthopaedic Trauma Surgeon, Penrose Hospital, 2222 North Nevada Ave., Colorado Springs, CO, 80907, USA.
M CarrickMedical City Plano, 3901 West 15th Street, Plano, TX, 75075, USA.
D Bar-OrSwedish Medical Center, 501 E Hampden Ave., Englewood, CO, 80113, USA. davidbme49@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMost guidelines recommend both pelvic packing (PP) and angioembolization for hemodynamically unstable pelvic fractures, however their sequence varies. Some argue to use PP first because orthopaedic surgeons are more available than interventional radiologists; however, there is no data confirming this.

methodsThis cross-sectional survey of 158 trauma medical directors at US Level I trauma centers collected the availability of orthopaedic surgeons and interventional radiologists, the number of orthopaedic trauma surgeons trained to manage pelvic fractures, and priority treatment sequence for hemodynamically unstable pelvic fractures. The study objective was to compare the availability of orthopaedic surgeons to interventional radiologists and describe how the availability of orthopaedic surgeons and interventional radiologists affects the treatment sequence for hemodynamically unstable pelvic fractures. Fisher's exact, chi-squared, and Kruskal-Wallis tests were used, alpha = 0.05.

resultsThe response rate was 25% (40/158). Orthopaedic surgeons (86%) were on-site more often than interventional radiologists (54%), p = 0.003. Orthopaedic surgeons were faster to arrive 39% of the time, and interventional radiologists were faster to arrive 6% of the time. There was a higher proportion of participants who prioritized PP before angioembolization at centers with above the average number (> 3) of orthopaedic trauma surgeons trained to manage pelvic fractures, as among centers with equal to or below average, p = 0.02. Arrival times for orthopaedic surgeons did not significantly predict prioritization of angioembolization or PP.

conclusionsOur results provide evidence that orthopaedic surgeons typically are more available than interventional radiologists but contrary to anecdotal evidence most participants used angioembolization first. Familiarity with the availability of orthopaedic surgeons and interventional radiologists may contribute to individual trauma center's treatment sequence.

Indexed as

Personnel Staffing and SchedulingSurveys and QuestionnairesEmbolization, TherapeuticFractures, BoneHemodynamicsHumansOrthopedic SurgeonsPelvic BonesPhysician ExecutivesRadiologistsTrauma CentersTreatment OutcomeUnited StatesAngioembolizationLevel I trauma centerOrthopaedic surgeonsPelvic fracture managementPelvic packingTrauma

Identifiers

PMID31801568
PMCPMC6894122

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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.