Evidence map›Paper›PMID 32606064›Full record

ArticleBMJ open2020

Identification of factors associated with morbidity and postoperative length of stay in surgically managed chronic subdural haematoma using electronic health records: a retrospective cohort study.

Daniel J Stubbs, Benjamin M Davies, Tom Bashford, Alexis J Joannides, Peter J Hutchinson, David K Menon, Ari Ercole, Rowan M Burnstein

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

Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 3 pooled it
1.3field-weighted citation impact, top 15% 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

10 citing papers in PubMed, 3 syntheses or guidelines pooled it, 28 citations in OpenAlex.

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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

8 authors at 2 institutions in 1 country.

Daniel J StubbsUniversity Division of Anaesthesia, Department of Medicine, University of Cambridge, Cambridge, UK djs225@cam.ac.uk.ORCID 0000-0003-2778-5226
Benjamin M DaviesDepartment of Clinical Neurosurgery, University of Cambridge, Cambridge, UK.ORCID 0000-0003-0591-5069
Tom BashfordUniversity Division of Anaesthesia, Department of Medicine, University of Cambridge, Cambridge, UK.ORCID 0000-0003-0228-9779
Alexis J JoannidesNIHR Brain Injury MedTech Co-operative, University of Cambridge, Cambridge, Cambridgeshire, UK.
Peter J HutchinsonAcademic Neurosurgery, University of Cambridge, Cambridge, UK.
David K MenonUniversity Division of Anaesthesia, Department of Medicine, University of Cambridge, Cambridge, UK.ORCID 0000-0002-3228-9692
Ari ErcoleUniversity Division of Anaesthesia, Department of Medicine, University of Cambridge, Cambridge, UK.ORCID 0000-0001-8350-8093
Rowan M BurnsteinNeurocritical Care Department and Department of Anaesthesia, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
University of Cambridge · GBCambridge University Hospitals NHS Foundation Trust · GB

Funding

Department of Health NIHR300696Wellcome Trust 204017/Z/16/Z
6 · The paper itself

Abstract

introductionChronic subdural haematoma (cSDH) tends to occur in older patients, often with significant comorbidity. The incidence and effect of medical complications as well as the impact of intraoperative management strategies are now attracting increasing interest.

objectivesWe used electronic health record data to study the profile of in-hospital morbidity and examine associations between various intraoperative events and postoperative stay. DESIGN, SETTING AND

participantsSingle-centre, retrospective cohort of 530 cases of cSDH (2014-2019) surgically evacuated under general anaesthesia at a neurosciences centre in Cambridge, UK. METHODS AND OUTCOME DEFINITION: Complications were defined using a modified Electronic Postoperative Morbidity Score. Association between complications and intraoperative care (time with mean arterial pressure <80 mm Hg, time outside of end-tidal carbon dioxide (ETCO

results53 (10%) patients suffered myocardial injury, while 24 (4.5%) suffered acute renal injury. On postoperative day 3 (D3), 280 (58% of remaining) inpatients suffered at least 1 complication. D7 rate was comparable (57%). Operative time was the only intraoperative event associated with postoperative stay (HR for discharge: 0.97 (95% CI: 0.95 to 0.99)). On multivariable analysis, postoperative complications (0.61 (0.55 to 0.68)), anticoagulation (0.45 (0.37 to 0.54)) and cognitive impairment (0.71 (0.58 to 0.87)) were associated with time to discharge.

conclusionsThere is a high postoperative morbidity burden in this cohort, which was associated with postoperative stay. We found no evidence of an association between intraoperative events and postoperative stay.

Indexed as

MorbidityAdultCohort StudiesElectronic Health RecordsFemaleHematoma, Subdural, ChronicHumansLength of StayMalePostoperative ComplicationsRetrospective StudiesSex Factorsanaestheticsepidemiologyneurosurgeryquality in health carestatistics & research methods

Identifiers

PMID32606064
PMCPMC7328896
OpenAlexW3035878438

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.