Evidence map›Paper›PMID 32822886›Full record

ArticleJournal of the American College of Surgeons2020

Improved Understanding of Acute Incisional Hernia Incarceration: Implications for Addressing the Excess Mortality of Emergent Repair.

Lauren V Huckaby, Esmaeel Reza Dadashzadeh, Robert Handzel, Alexa Kacin, Matthew R Rosengart, Dirk J van der Windt

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

Article in Journal of the American College of Surgeons, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
1.4field-weighted citation impact, top 18% 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, 12 citations in OpenAlex.

  1. Trial
  2. Article
  3. Review
  4. Mapping the therapeutic landscape in emergency incisional hernia: a scoping review.Hernia : the journal of hernias and abdominal wall surgery · 2025
    Article
  5. Article
  6. Article
  7. Operative management of non-elective incisional hernia reduces readmission in a national database.Hernia : the journal of hernias and abdominal wall surgery · 2023
    Article
  8. Article
  9. Ventral hernia repair under neuraxial anesthesia.European surgery : ACA : Acta chirurgica Austriaca · 2022
    Article
  10. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Lauren V HuckabyDepartment of Surgery, University of Pittsburgh, Pittsburgh, PA.
Esmaeel Reza DadashzadehDepartment of Surgery, University of Pittsburgh, Pittsburgh, PA; Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA.
Robert HandzelDepartment of Surgery, University of Pittsburgh, Pittsburgh, PA; Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA.
Alexa KacinDepartment of Surgery, University of Pittsburgh, Pittsburgh, PA.
Matthew R RosengartDepartment of Surgery, University of Pittsburgh, Pittsburgh, PA; Pittsburgh Surgical Outcomes Research Center, University of Pittsburgh, Pittsburgh, PA.
Dirk J van der WindtDepartment of Surgery, University of Pittsburgh, Pittsburgh, PA. Electronic address: vandirk@med.umich.edu.
University of Pittsburgh · US

Funding

Vascular Surgery Research Training (VascTrain) ProgramT32HL098036 · NHLBI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI Edith Tzeng · 2010 to 2026
$7.2M
NHLBI NIH HHS T32 HL098036
6 · The paper itself

Abstract

backgroundIncisional hernia develops in up to 20% of patients undergoing abdominal operations. We sought to identify characteristics associated with poor outcomes after acute incisional hernia incarceration. STUDY

designWe performed a retrospective cohort study of adult patients with incisional hernias undergoing elective repair or with acute incarceration between 2010 and 2017. The primary end point was 30-day mortality. Logistic regression was used to determine adjusted odds associated with 30-day mortality. The American College of Surgeons Surgical Risk Calculator was used to estimate outcomes had these patients undergone elective repair.

resultsA total of 483 patients experienced acute incarceration; 30-day mortality was 9.52%. Increasing age (adjusted odds ratio 1.05; 95% CI, 1.02 to 1.08) and bowel resection (adjusted odds ratio 3.18; 95% CI, 1.45 to 6.95) were associated with mortality. Among those with acute incarceration, 231 patients (47.9%) had no documentation of an earlier surgical evaluation and 252 (52.2%) had been evaluated but had not undergone elective repair. Among patients 80 years and older, 30-day mortality after emergent repair was high (22.9%) compared with estimated 30-day mortality for elective repair (0.73%), based on the American College of Surgeons Surgical Risk Calculator. Estimated mortality was comparable with observed elective repair mortality (0.82%) in an age-matched cohort. Similar mortality trends were noted for patients younger than 60 years and aged 60 to 79 years.

conclusionsComparison of predicted elective repair and observed emergent repair mortality in patients with acute incarceration suggests that acceptable outcomes could have been achieved with elective repair. Almost one-half of acute incarceration patients had no earlier surgical evaluation, therefore, targeted interventions to address surgical referral can potentially result in fewer incarceration-related deaths.

Indexed as

HerniorrhaphyAbdomenAcute DiseaseAgedAged, 80 and overAge FactorsFemaleHumansIncisional HerniaMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesRisk FactorsSurvival Rate

Identifiers

PMID32822886
PMCPMC9057450
OpenAlexW3065307076

What OpenQuestion holds

Textmetadata
LicenceTDM
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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.