Evidence map›Paper›PMID 33555526›Full record

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

Clinical and Cost Profile of Controlled Grade B Postoperative Pancreatic Fistula: Rationale for Their Consideration as Low Risk.

Alexandra W Acher, Christopher Stahl, James R Barrett, Patrick B Schwartz, Taylor Aiken, Sean Ronnekleiv-Kelly, Rebecca M Minter, Glen Leverson, Sharon M Weber, Daniel E Abbott

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In one paragraph

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 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
–field-weighted citation impact
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.

  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

10 authors.

Alexandra W AcherDepartment of General Surgery, Division of Surgical Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53792, USA. acher@wisc.edu.ORCID http://orcid.org/0000-0001-9314-8095
Christopher StahlDepartment of General Surgery, Division of Surgical Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53792, USA.
James R BarrettDepartment of General Surgery, Division of Surgical Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53792, USA.
Patrick B SchwartzDepartment of General Surgery, Division of Surgical Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53792, USA.
Taylor AikenDepartment of General Surgery, Division of Surgical Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53792, USA.
Sean Ronnekleiv-KellyDepartment of General Surgery, Division of Surgical Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53792, USA.
Rebecca M MinterDepartment of General Surgery, Division of Surgical Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53792, USA.
Glen LeversonDepartment of General Surgery, Division of Surgical Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53792, USA.
Sharon M WeberDepartment of General Surgery, Division of Surgical Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53792, USA.
Daniel E AbbottDepartment of General Surgery, Division of Surgical Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53792, USA.

Funding

UW Surgical Oncology Research Training Program (UW-SORT)T32CA090217 · NCI · UNIVERSITY OF WISCONSIN-MADISON · PI Muhammed Murtaza, Heather B Neuman · 2001 to 2026
$8.3M
NCI NIH HHS T32 CA090217
6 · The paper itself

Abstract

backgroundDespite standardization, the 2016 ISGPF criteria are limited by their wider applicability and oversimplification of grade B POPF. This work applied the 2016 ISGPF grading criteria within a US academic cancer center to verify clinical and fiscal distinctions and sought to improve grading criteria for grade B POPF.

methodsThe 2008-2018 cost and NSQIP data from pancreaticoduodenectomy to postoperative day 90 were merged. All POPFs were coded by 2016 ISGPF criteria. The Clavien-Dindo Classification (CD) defined complication severity. On sub-analyses, grade B POPFs were divided into those with adequate drainage and those requiring additional drainage. Chi-square, ANOVA, and Fisher's least significant difference test were employed.

resultsTwo hundred thirty-two patients were in the final analyses, 72 (31%) of whom had POPFs: 16 (7%) biochemical leaks, 54 (23%) grade B (28% required additional drainage), and 2 (1%) grade C. There was no significant difference in length of stay, CD, readmission, or cost in patients without a POPF, with biochemical leak or grade B POPF. On sub-analyses, 92% of adequately drained grade B POPFs had CD 1-2 and readmission equivalent to patients without POPF (p > 0.05). One hundred percent of grade B POPF requiring drainage had CD 3-4a, and 67% were readmitted. Cost was significantly increased in grade B POPF requiring additional drainage (p = 0.02) and grade C POPF (p < 0.01).

conclusionsThis analysis did not confirm an incremental increase in morbidity and cost with POPF grade. Sub-analyses enabled accurate clinical and cost distinctions in grade B POPF; adequately drained grade B POPF are low risk and clinically insignificant.

Indexed as

Pancreatic FistulaPancreaticoduodenectomyHumansPancreasPancreatectomyPostoperative ComplicationsRisk FactorsCostPancreatic fistulaPancreaticoduodenectomyPOPFWhipple

Identifiers

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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.