Evidence map›Paper›PMID 33025254›Full record

ArticleSurgical endoscopy2021

Recent trends in cholecystectomy in US veterans.

Joshua Kong, Awni Shahait, Kara Girten, Mohanad Baldawi, Mustafa Rashad Hasnain, Khaled J Saleh, Scott A Gruber, Donald Weaver, Gamal Mostafa

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In one paragraph

Article in Surgical endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.3field-weighted citation impact, top 38% 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

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 5 citations in OpenAlex.

  1. Pooled it
  2. 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

9 authors at 3 institutions in 1 country.

Joshua KongMichael and Marian Ilitch Department of Surgery, Wayne State University/Detroit Medical Center, 6C, University Health Center, 4201 St. Antoine, Detroit, MI48201, USA.
Awni ShahaitMichael and Marian Ilitch Department of Surgery, Wayne State University/Detroit Medical Center, 6C, University Health Center, 4201 St. Antoine, Detroit, MI48201, USA.
Kara GirtenDepartment of Surgery, John D. Dingell Veteran Affairs Medical Center, Detroit, MI, 48201, USA.
Mohanad BaldawiDepartment of Surgery, John D. Dingell Veteran Affairs Medical Center, Detroit, MI, 48201, USA.
Mustafa Rashad HasnainDepartment of Surgery, John D. Dingell Veteran Affairs Medical Center, Detroit, MI, 48201, USA.
Khaled J SalehDepartment of Surgery, John D. Dingell Veteran Affairs Medical Center, Detroit, MI, 48201, USA.
Scott A GruberMichael and Marian Ilitch Department of Surgery, Wayne State University/Detroit Medical Center, 6C, University Health Center, 4201 St. Antoine, Detroit, MI48201, USA.
Donald WeaverMichael and Marian Ilitch Department of Surgery, Wayne State University/Detroit Medical Center, 6C, University Health Center, 4201 St. Antoine, Detroit, MI48201, USA.
Gamal MostafaMichael and Marian Ilitch Department of Surgery, Wayne State University/Detroit Medical Center, 6C, University Health Center, 4201 St. Antoine, Detroit, MI48201, USA. gmostafa@med.wayne.edu.
John D. Dingell VA Medical Center · USDetroit Medical Center · USWayne State University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionWe hypothesize that the recent trend in performing cholecystectomy in US Veterans shows wide adoption of the laparoscopic technique and improvement in the outcome following both laparoscopic (LC) and open cholecystectomy (OC). This study utilizes the Veterans Affairs Surgical Quality Improvement Program database to examine the status and outcome of cholecystectomy.

methodsA retrospective review of veterans who underwent cholecystectomy between 2008 and 2015 was performed. Data analysis included patient demographics, operations, and postoperative outcomes. Cochran-Armitage trend analysis was used to assess significant changes in outcome over the study period. p ≤ 0.05 was considered significant.

resultsA total of 40,722 patients (average age of 61 years) were included in the study (males 85.6%). LC was performed in the majority of patients (86.4%). Patients in the OC group (13.6%) were more likely to have advanced age (≥ 65 years) (47.6% vs 32.0%, p < 0.001) and higher ASA class (III-V) (81.9% vs 65.4%, p < 0.001) than those in the LC group. Compared with LC, OC had higher mortality rates at 30 days (1.3% vs 0.3%; OR = 1.6, p = 0.03), 3 months (2.6% vs 0.7%; OR = 1.7, p < 0.001), 6 months (3.9% vs 1.1%; OR = 1.5, p < 0.001) and 1 year (5.7% vs 2.0%; OR = 1.5, p < 0.001); higher rates of morbidity, including pneumonia (OR = 1.9, p < 0.001), deep venous thrombosis (OR = 2.4, p = 0.02), reoperation (OR = 1.8, p < 0.001), and superficial (OR = 4.9, p < 0.001) and deep (OR = 1.5, p = 0.01) surgical site infections; and a longer length of stay (6.5 days vs 2.6 days, p < 0.001). Trend analysis showed a significant decrease in both mortality (p = 0.02) and morbidity (p < 0.001) for LC over the study period, but no improvement in mortality (p = 0.35) and a only a minimal improvement in morbidity (p = 0.04) for OC.

conclusionIn the recent era, LC has been widely performed in the VA with significant improvement in outcome. Efforts are needed to adopt alternative approaches to planned OC and to improve postoperative outcomes.

Indexed as

Cholecystectomy, LaparoscopicVeteransAgedCholecystectomyHumansLength of StayMaleMiddle AgedPostoperative ComplicationsRetrospective StudiesLaparoscopic cholecystectomyOpen cholecystectomyPractice trendsPredictorsSurgical outcomesVeterans affairs

Identifiers

PMID33025254
OpenAlexW3092371558

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.