Evidence map›Paper›PMID 34276086›Full record

ArticleThe Ulster medical journal2021

A

D Colvin, S Lawther

Open access · greenAbstract read
In one paragraph

Article in The Ulster medical journal, 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
1.2field-weighted citation impact, top 21% 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

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  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

2 authors at 1 institution in 1 country.

D ColvinDepartment of Paediatric Surgery, The Royal Belfast Hospital for Sick Children, Belfast, UK.
S LawtherDepartment of Paediatric Surgery, The Royal Belfast Hospital for Sick Children, Belfast, UK.
Royal Belfast Hospital for Sick Children · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTraditional surgical dogma is that paediatric appendicitis necessitates an appendicectomy; however there is an increasing cohort of evidence suggesting that non-operative management (NOM) using antibiotic therapy is safe and effective. During the COVID-19 surge (April - June 2020) with centralization of paediatric surgical care and risks from anaesthetics to both patients and staff a NOM pathway was used to manage clinically diagnosed appendicitis in the Royal Belfast Hospital for Sick Children (RBHSC).

methodsProspective data collection was undertaken of all children (<16 years) diagnosed with appendicitis who entered the NOM pathway in RBHSC from 01/04/2020 to 30/06/2020. This was compared to a cohort from the same timeframe in 2019. Primary end-points were inpatient success rate of NOM and 30-day success rate of NOM (success defined as no appendectomy performed).

results47 patients completed the NOM pathway, with 43% (20/47) suspected to have complicated appendicitis. The cohort was similar to that of 2019 in terms of age (p=0.1) and sex (p=0.8), but was 155% larger (42 v. 20).For those with simple appendicitis, there was a 96% (26/27) success rate of NOM on discharge, with a 93% (25/27) 30-day success rate. For complicated appendicitis, there was a 40% (8/20) success rate on discharge, with a 30% (6/20) 30-day success rate.

conclusionThe use of a NOM pathway for paediatric appendicitis during the COVID-19 surge in Northern Ireland was safe and effective for staff and patients. With a small sample size and restricted follow up more evidence is required to prove if this is an effective treatment modality with a return to normal theatre availability. In the interests of antibiotic stewardship we would not advocate NOM pathways utilisation by non-surgical clinicians.

Indexed as

Anti-Bacterial AgentsAppendectomyAppendicitisChildCOVID-19FemaleHospitals, PediatricHumansMaleNorthern IrelandPneumonia, ViralProspective StudiesSARS-CoV-2Anti-Bacterial AgentsantibioticsappendicitisCOVID-19non-operativepaediatric

Identifiers

PMID34276086
PMCPMC8278940
OpenAlexW3186331995

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-SA
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.