Evidence map›Paper›PMID 33831540›Full record

ArticleJournal of the American College of Surgeons2021

National Population Study of the Effect of Structure and Process on Outcomes of Digit Replantation.

Chung-Chen Hsu, Sunitha Malay, Jung-Sheng Chen, Charles Yuen Yung Loh, Yu-Te Lin, Kevin C Chung

Abstract read
In one paragraph

Article in Journal of the American College of Surgeons, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Indications for replantation and factors that predict success.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2024
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Chung-Chen HsuDepartment of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, the College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Sunitha MalaySection of Plastic Surgery Department of Surgery University of Michigan Medical School, Ann Arbor, MI.
Jung-Sheng ChenCenter for Artificial Intelligence in Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Charles Yuen Yung LohDepartment of Plastic and Reconstructive Surgery, Addenbrooke's Hospital, Hills Road, Cambridge, United Kingdom, CB2 0QQ, UK.
Yu-Te LinDepartment of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, the College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Kevin C ChungSection of Plastic Surgery Department of Surgery University of Michigan Medical School, Ann Arbor, MI; Charles BG de Nancrede Professor of Surgery, Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School, Ann Arbor, MI. Electronic address: kecchung@umich.edu.

Funding

University of Michigan Fibromyalgia CORTP50AR070600 · NIAMS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI CLAUW, DANIEL J · 2016 to 2021
$7.4M
A Clinical Trial for the Surgical Treatment of Elderly Distal Radius FracturesR01AR062066 · NIAMS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI CHUNG, KEVIN C · 2011 to 2016
$3.8M
Research methodology to assess surgery for ulnar neuropathy at the elbowU01AR073485 · NIAMS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI CHUNG, KEVIN C · 2019 to 2024
$3.5M
TRAINING GRANT IN TRAUMA, BURN AND WOUND HEALING RESEARCT32GM008616 · NIGMS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI BUCHMAN, STEVEN R, CHUNG, KEVIN C · 1997 to 2025
$3.1M
Evidence-Based Research in Hand SurgeryK24AR053120 · NIAMS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI CHUNG, KEVIN C · 2008 to 2018
$1.6M
NIAMS NIH HHS K24 AR053120NIAMS NIH HHS P50 AR070600NIAMS NIH HHS R01 AR062066NIAMS NIH HHS U01 AR073485NIGMS NIH HHS T32 GM008616
6 · The paper itself

Abstract

backgroundSurgeon experience, hospital volume, and teaching hospital status may play a role in the success of digit replantation. This study aims to analyze factors that influence digit replantation success rates. STUDY

designWe examined patients with traumatic digit amputations, between 2000 and 2015, from the National Health Insurance Research Database (NHIRD) of Taiwan, which comprises data of more than 99% of its population. We measured the number of traumatic digit amputations and success rate of replantation. Chi-square and ANOVA tests were used for descriptive statistics. Regression models were built to analyze the association among patient, surgeon, and hospital characteristics, and replant success.

resultsWe identified 13,416 digit replantation patients using the eligibility criteria. The overall replantation failure rate was significantly higher in medium- and high-volume hospitals (low-volume: 11%, medium-volume: 17%, and high-volume: 15%, p < 0.001). Teaching hospitals had significantly higher replantation failure rates [(15.5% vs 7.6%), odds ratio (OR) 2.0; confidence interval (CI) 1.1-3.7]. Lower surgeon case volume resulted in a significantly higher failure rate in the thumb replantation (OR 0.89; CI 0.85-0.94).

conclusionsTeaching hospitals had greater odds of replantation failure, owing to being high volume centers and attempting more replantations. However, the effect of residents performing the replantation during their training should be considered. Teaching units are mandatory for resident training; however, a balance should be established to provide training, but with sufficient supervision to achieve optimal replant success. A national protocol to triage digit amputation cases to high volume centers with experienced microsurgeons will help improve the replantation success rate.

Indexed as

AdolescentAdultAgedAmputation, TraumaticFemaleFinger InjuriesHospitals, High-VolumeHospitals, Low-VolumeHospitals, TeachingHumansInternship and ResidencyMaleMicrosurgeryMiddle AgedOdds RatioReplantation

Identifiers

PMID33831540
PMCPMC10167636

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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.