Evidence map›Paper›PMID 33208295›Full record

ArticleThe journal of sexual medicine2020

Risk Factors for Surgical Shunting in a Large Cohort With Ischemic Priapism.

Hanson Zhao, Kai Dallas, John Masterson, Eric Lo, Justin Houman, Carl Berdahl, Joshua Pevnick, Jennifer T Anger

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

Article in The journal of sexual medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.6field-weighted citation impact, top 32% 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 1 country.

Hanson ZhaoDivision of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Kai DallasDivision of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
John MastersonDivision of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Eric LoDepartment of Urology, Baylor College of Medicine, Houston, TX, USA.
Justin HoumanDivision of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Carl BerdahlDepartment of Emergency Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA; Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Joshua PevnickDepartment of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Jennifer T AngerDivision of Urology, Cedars-Sinai Medical Center, Los Angeles, CA, USA. Electronic address: Jennifer.Anger@cshs.org.
University of California, Los Angeles · USCedars-Sinai Medical Center · USLos Angeles Medical Center · USUrology San Antonio · US

Funding

UCLA Clinical Translational Science InstituteUL1TR001881 · NCATS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI ARLEEN F. BROWN, ARASH NAEIM · 2016 to 2026
$118.1M
UCLA Clinical and Translational Science InstituteUL1TR000124 · NCATS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI DUBINETT, STEVEN M. · 2012 to 2015
$57.0M
Minimizing Errors in Medication Histories Obtained at Hospital AdmissionK23AG049181 · NIA · CEDARS-SINAI MEDICAL CENTER · PI PEVNICK, JOSHUA M · 2015 to 2018
$707k
NCATS NIH HHS UL1 TR000124NCATS NIH HHS UL1 TR001881NIA NIH HHS K23 AG049181
6 · The paper itself

Abstract

backgroundIschemic priapism is treated with a stepwise algorithm, but some patients may benefit from immediate shunt placement.

aimTo identify risk factors for surgical shunt placement in a large series of patients with ischemic priapism.

methodsWe identified all patients presenting to our institution with ischemic priapism from January 2010 to December 2018. Multivariable was performed to assess risk factors for surgical shunting. Receiver operating characteristic curve analysis (Youden Index) was used to assess which cutoff time for the duration of priapism was most predictive requiring shunting. OUTCOMES: We assess risk factors for surgical shunting and what duration of priapism was most predictive of requiring a shunt.

resultsWe identified a total of 169 ischemic priapism encounters from 143 unique patients, of which 26 (15%) encounters resulted in a surgical shunt. Patients treated with a shunt had longer priapism durations than those without (median 36 vs 10 hours, P < .001). Independent predictors of a surgical shunt on multivariate logistic regression were the duration of priapism in hours (odds ratio: 1.05, 95% confidence interval: 1.02-1.10; P < .001) and history of prior priapism (odds ratio: 3.15, 95% confidence interval: 1.03-9.60; P = .045). Receiver operating characteristic curve analysis using priapism duration to predict the need for shunt generated an area under curve of 0.83. A duration of 24 hours correlated to a sensitivity of 0.77 and specificity of 0.90. CLINICAL IMPLICATIONS: These results can be used to counsel future patients and assist in the decision-making process for providers. STRENGTHS & LIMITATIONS: This is one of the largest series of priapism in the literature. Most (74%) of the priapism were due to intracavernosal injections so the results may not be generalizable to populations with different priapism etiologies.

conclusionIn this study of 169 priapism encounters, we found that the priapism duration and history of prior priapism were independent predictors of surgical shunt placement. These results can aid urologists in the counseling and decision-making process of these challenging cases. Zhao H, Dallas K, Masterson J, et al. Risk Factors for Surgical Shunting in a Large Cohort With Ischemic Priapism. J Sex Med 2020;17:2472-2477.

Indexed as

PriapismCohort StudiesHumansMalePenisRisk FactorsTime FactorsIntracavernosal InjectionsIschemic PriapismPriapismSurgical Shunt

Identifiers

PMID33208295
PMCPMC8136145
OpenAlexW3103296754

What OpenQuestion holds

Textmetadata
LicenceTDM
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.