Evidence map›Paper›PMID 33604218›Full record

ArticleCureus2021

Lessons for Emergency Surgery in the Second Wave: One-Month Single-Centre Experience During the First Wave of COVID-19.

Taner Shakir, Muhammad Rafaih Iqbal, Nourelhuda M Darwish, Naveed Kirmani

Open access · diamondAbstract read
In one paragraph

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

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
0.3field-weighted citation impact, top 44% 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

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

  1. Pooled it
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

4 authors at 1 institution in 1 country.

Taner ShakirGeneral Surgery, Princess Alexandra Hospital NHS Trust, Harlow, GBR.
Muhammad Rafaih IqbalGeneral Surgery, Princess Alexandra Hospital NHS Trust, Harlow, GBR.
Nourelhuda M DarwishGeneral Surgery, Princess Alexandra Hospital NHS Trust, Harlow, GBR.
Naveed KirmaniGeneral Surgery, Princess Alexandra Hospital NHS Trust, Harlow, GBR.
Princess Alexandra Hospital NHS Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction The global COVID-19 pandemic had a deleterious effect upon elective and emergency surgery. Focus of patient care was directed to emergency services. Association of Surgeons of Great Britain and Northern Ireland guidelines advised a trend towards conservative management. Traditional surgical intervention was reserved only for selected cases only. We evaluated our emergency practice over a four-week period during the first peak of COVID-19. Methods A retrospective single-centre analysis was performed of consecutive patients seen by the emergency general and vascular surgery on-call team in a District General Hospital over a four-week period (30 March 2020-26 April 2020). Primary outcome was 30-day COVID-19 mortality. Secondary outcomes were 30-day complications, readmission rate and non-COVID-19-related mortality. Adherence to intercollegiate guidelines was also assessed.  Results A total of 184 patients were assessed during the period. The median age was 55 years (interquartile range 34-75), with a male:female ratio of 1:0.7. Thirty-day COVID-19- and non-COVID-19-related mortalities were 3% and 8%, respectively. Thirteen percent of patients developed complications and 9% represented to the emergency department within 30 days. Conservative management was initially employed in 78% of patients. This had success rates in appendicitis and cholecystitis of 72% and 75%, respectively. A CT thorax was included in 89% having a CT abdomen and pelvis. Thirty-eight percent had a COVID-19 polymerase chain reaction (PCR) swab test performed throughout the study period. Fifty-two percent of individuals who underwent emergency surgery had a swab performed prior to operative intervention. Conclusions Conservative management seems to be reasonably effective and may re-shape the way we treat a proportion of surgical pathologies in the future. Further long-term data are required in order to evaluate this. A paucity of PCR testing was due to nationwide capacity shortcomings. This must be addressed in future peaks with rapid testing in order to triage patients to the appropriate setting.

Indexed as

covid-19emergency surgery

Identifiers

PMID33604218
PMCPMC7880856
OpenAlexW3120807351

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.