Evidence map›Paper›PMID 31965440›Full record

ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2021

The Impact of Preoperative Anti-TNFα Therapy on Postoperative Outcomes Following Ileocolectomy in Crohn's Disease.

Afif N Kulaylat, Audrey S Kulaylat, Eric W Schaefer, Katelin Mirkin, Andrew Tinsley, Emmanuelle Williams, Walter A Koltun, Christopher S Hollenbeak, Evangelos Messaris

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Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
1.6field-weighted citation impact, top 17% 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

9 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Observational
  5. Article
  6. Article
  7. Review
  8. Preoperative Anti-TNF Agents and Morbidity After Ileocolonic Resections in Crohn's Disease: Are Biologics the Only Ones to Blame?Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021
    Article
  9. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Afif N KulaylatDepartment of Surgery, Nationwide Children's Hospital, Ohio State University, Columbus, OH, USA.
Audrey S KulaylatDepartment of Surgery, College of Medicine, The Pennsylvania State University, Hershey, PA, USA.
Eric W SchaeferDepartment of Public Health Sciences, College of Medicine, The Pennsylvania State University, Hershey, PA, USA.
Katelin MirkinDepartment of Surgery, College of Medicine, The Pennsylvania State University, Hershey, PA, USA.
Andrew TinsleyDepartment of Medicine, College of Medicine, The Pennsylvania State University, Hershey, PA, USA.
Emmanuelle WilliamsDepartment of Medicine, College of Medicine, The Pennsylvania State University, Hershey, PA, USA.
Walter A KoltunDepartment of Surgery, College of Medicine, The Pennsylvania State University, Hershey, PA, USA.
Christopher S HollenbeakDepartment of Health Policy and Administration, College of Health and Human Development, The Pennsylvania State University, State College, PA, USA.
Evangelos MessarisDepartment of Surgery, Harvard Medical School Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02215, USA. emessari@bidmc.harvard.edu.
Pennsylvania State University · USHarvard University · USNationwide Children's Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundControversy remains regarding the impact of anti-TNFα agents on postoperative outcomes in Crohn's disease.

methodsPatients (≥ 18 years) with Crohn's disease (ICD-9, 555.0-555.2, 555.9) undergoing ileocolectomy between 2005 and 2013 were identified using the Truven MarketScan® database and stratified by receipt of anti-TNFα therapy. Multivariable logistic regression was performed to evaluate anti-TNFα use on emergency department (ED) visits, postoperative complications, and readmissions at 30 days, adjusting for potential confounders. Relationships between timing of anti-TNFα administration and outcomes were examined.

resultsThe sample contained 2364 patients with Crohn's disease undergoing ileocolectomy, with 28.5% (n = 674) who received biologic therapy. Median duration between anti-TNFα therapy and surgery was 33 days. Postoperative ED visits and readmission rates did not significantly differ among those receiving biologics and those that did not. Overall 30-day complication rates were higher among those receiving biologic therapy, namely related to wound and infectious complications. In multivariable analysis, anti-TNFα inhibitors were associated with increased odds of postoperative complications at 30 days (aggregate complications [OR 1.6], infectious complications [OR 1.5]). There was no significant association between timing of anti-TNFα administration and occurrence of postoperative outcomes.

conclusionAnti-TNFα therapy is independently associated with increased postoperative infectious complications following ileocolectomy in Crohn's disease. However, in patients receiving anti-TNFα therapy within 90 days of operative intervention, further delaying surgery may not attenuate risk of postoperative complications.

Indexed as

Crohn DiseaseAnastomosis, SurgicalColectomyHumansPostoperative ComplicationsPostoperative PeriodBiologicInfectionInflammatory bowel diseaseReadmission

Identifiers

PMID31965440
OpenAlexW3001706564

What OpenQuestion holds

Textmetadata
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.