Evidence map›Paper›PMID 35102437›Full record

ArticleWorld journal of surgery2022

Surgical Outcomes in Canada and the United States: An Analysis of the ACS-NSQIP Clinical Registry.

Peter Cram, Mark E Cohen, Clifford Ko, Bruce E Landon, Bruce Hall, Timothy D Jackson

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in World journal of surgery, 2022. 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
1.7field-weighted citation impact, top 17% 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

4 citing papers in PubMed, 8 citations in OpenAlex.

  1. The Association Between Hispanic Ethnicity, Cholecystectomy, and Postoperative Mortality.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2026
    Article
  2. Article
  3. Antimicrobial approach of abdominal post-surgical infections.World journal of gastrointestinal surgery · 2023
    Review
  4. Challenges and opportunities in providing high-quality surgical care in Canada.Canadian journal of surgery. Journal canadien de chirurgie
    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

6 authors at 5 institutions in 2 countries.

Peter CramDepartment of Medicine, University of Toronto, Toronto, ON, Canada. pecram@utmb.edu.ORCID http://orcid.org/0000-0002-1910-346X
Mark E CohenAmerican College of Surgeons, Chicago, IL, USA.
Clifford KoAmerican College of Surgeons, Chicago, IL, USA.
Bruce E LandonDepartment of Health Care Policy, Harvard Medical School and Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, USA.
Bruce HallAmerican College of Surgeons, Chicago, IL, USA.
Timothy D JacksonDepartment of Surgery, University of Toronto, Toronto, Canada.
University Health Network · CAAmerican College of Surgeons · USBeth Israel Deaconess Medical Center · USBJC HealthCare · USVA West Los Angeles Medical Center · US

Funding

Comparing hospitalization rates, outcomes, and treatment intensity for elderly patients across OECD countriesR01AG058878 · NIA · HARVARD MEDICAL SCHOOL · PI Peter M Cram, Bruce E. Landon · 2019 to 2026
$3.4M
NIA NIH HHS R01 AG058878NIA NIH HHS R01AG058878
6 · The paper itself

Abstract

backgroundThere has been longstanding uncertainty over whether lower healthcare spending in Canada might be associated with inferior outcomes for hospital-based care. We hypothesized that mortality and surgical complication rates would be higher for patients who underwent four common surgical procedures in Canada as compared to the US. DESIGN, SETTING, AND

participantsWe conducted a retrospective cohort study of all adults who underwent hip fracture repair, colectomy, pancreatectomy, or spine surgery in 96 Canadian and 585 US hospitals participating in the American College of Surgeons National Surgical Quality Improvement Project (ACS-NSQIP) between January 1, 2015 and December 31, 2019. We compared patients with respect to demographic characteristics and comorbidity. We then compared unadjusted and adjusted outcomes within 30-days of surgery for patients in Canada and the US including: (1) Mortality; (2) A composite constituting 1-or-more of the following complications (cardiac arrest; myocardial infarction; pneumonia; renal failure/; return to operating room; surgical site infection; sepsis; unplanned intubation).

resultsOur hip fracture cohort consisted of 21,166 patients in Canada (22.3%) and 73,817 in the US (77.7%), for colectomy 21,279 patients in Canada (8.9%) and 218,307 (91.1%), for pancreatectomy 873 (7.8%) in Canada and 12,078 (92.2%) in the US, and for spine surgery 14,088 (5.3%) and 252,029 (94.7%). Patient sociodemographics and comorbidity were clinically similar between jurisdictions. In adjusted analyses odds of death was significantly higher in Canada for two procedures (colectomy (OR 1.22; 95% CI 1.044-1.424; P = .012) and pancreatectomy (OR 2.11; 95% CI 1.26-3.56; P = .005)) and similar for hip fracture and spine surgery. Odds of the composite outcome were significantly higher in Canada for all 4 procedures, largely driven by higher risk of cardiac events and post-operative infections.

conclusionsWe found evidence of higher rates of mortality and surgical complications within 30-days of surgery for patients in Canada as compared to the US.

Indexed as

Postoperative ComplicationsQuality ImprovementAdultCanadaHumansRegistriesRetrospective StudiesTreatment OutcomeUnited States

Identifiers

PMID35102437
PMCPMC9929717
OpenAlexW4210540890

What OpenQuestion holds

Textmetadata
LicenceTDM
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.