Evidence map›Paper›PMID 33726715›Full record

ArticleBMC surgery2021

Role for colorectal teams to support non-colorectal teams to improve clinical outcomes and adherence to ERAS guidelines for segmental colectomy: a cohort study.

Simonette R Mallard, Kari A Clifford, R Park, Trainee Intern Research Group, Kim Cousins, Ann Patton, John C Woodfield, Mark Thompson-Fawcett

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–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

4 citing papers in PubMed.

  1. Trial
  2. Article
  3. Article
  4. SEX AND ASA CLASSIFICATION, NOT FASTING TIME, ARE ASSOCIATED WITH THE LIKELIHOOD OF COMPLICATIONS IN THE POSTOPERATIVE PERIOD.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2024
    Observational
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

8 authors.

Simonette R Mallard *Department of Surgical Sciences, Dunedin Medical Campus, Otago Medical School, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
Kari A Clifford *Department of Surgical Sciences, Dunedin Medical Campus, Otago Medical School, University of Otago, PO Box 56, Dunedin, 9054, New Zealand. kari.clifford@otago.ac.nz.
R ParkDepartment of Surgical Sciences, Dunedin Medical Campus, Otago Medical School, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
Trainee Intern Research Group
Kim CousinsDepartment of Preventive and Social Medicine, Dunedin Medical Campus, Otago Medical School, University of Otago, Dunedin, New Zealand.
Ann PattonDunedin Public Hospital, Dunedin, New Zealand.
John C WoodfieldDepartment of Surgical Sciences, Dunedin Medical Campus, Otago Medical School, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
Mark Thompson-FawcettDepartment of Surgical Sciences, Dunedin Medical Campus, Otago Medical School, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo identify whether compliance with Enhanced Recovery After Surgery (ERAS) Society recommendations is associated with length of stay (LOS) in a New Zealand hospital for patients undergoing segmental colectomy in mixed acute and elective general surgery wards.

methodsConsecutive elective colorectal surgeries (n = 770) between October 2012 and February 2019 were audited. Patients with non-segmental colectomies, multi-organ surgeries, LOS > 14 days, and those who died were excluded. Logistic regression was used to determine the relationship between patient demographics, compliance with ERAS guidelines, and suboptimal LOS (> 4 days).

resultsAnalysis included 376 patients. Age, surgery prior to 2014, surgical approach, non-colorectal surgical team, operation type, and complications were significantly associated with suboptimal LOS. Non-compliance with ERAS recommendations for laparoscopy [OR 8.9, 95% CI (4.52, 19.67)], removal of indwelling catheters (IDC) [OR 3.14, 95% CI (1.85, 5.51)], use of abdominal drains [OR 4.27, 95% CI (0.99, 18.35)], and removal of PCA [OR 8.71, 95% CI (1.78, 157.27)], were associated with suboptimal LOS (univariable analysis). Multivariable analysis showed that age, surgical team, late removal of IDC, and open approach were independent predictors of suboptimal LOS.

conclusionsNon-compliance with ERAS guidelines for laparoscopic approach and early removal of IDC was higher among procedures performed by non-colorectal surgery teams, and was also associated with adverse postoperative events and suboptimal LOS. This study demonstrates the importance of the surgical team's expertise in affecting surgical outcomes, and did not find significant independent associations between most individual ERAS guidelines and suboptimal LOS once adjusting for other factors.

Indexed as

ColectomyInterprofessional RelationsPatient Care TeamProfessional RoleCohort StudiesElective Surgical ProceduresEnhanced Recovery After SurgeryGuideline AdherenceHumansLength of StayNew ZealandPractice Guidelines as TopicTreatment OutcomeColorectal surgeryERASLaparoscopyLength of staySegmental colectomy

Identifiers

PMID33726715
PMCPMC7962301

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Registered trials

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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.