Evidence map›Paper›PMID 35849298›Full record

ArticleAnnals of surgical oncology2022

Postoperative Hematomas in the Era of Outpatient Mastectomy: Is Ketorolac Really to Blame?

Sami M Abujbarah, Kristen Jogerst, Heidi E Kosiorek, Sarwat Ahmad, Patricia A Cronin, William Casey, Ryan Craner, Alanna Rebecca, Barbara A Pockaj

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Article in Annals of surgical oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.0field-weighted citation impact, top 25% 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, 7 citations in OpenAlex.

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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

9 authors at 4 institutions in 1 country.

Sami M AbujbarahMayo Clinic Alix School of Medicine, Arizona Campus, Scottsdale, AZ, USA.
Kristen JogerstDepartment of General Surgery, Division of Surgical Oncology, Mayo Clinic Arizona, Phoenix, AZ, USA.
Heidi E KosiorekDepartment of Research-Biostatistics, Mayo Clinic Arizona, Phoenix, AZ, USA.
Sarwat AhmadDepartment of General Surgery, Division of Surgical Oncology, Mayo Clinic Arizona, Phoenix, AZ, USA.
Patricia A CroninDepartment of General Surgery, Division of Surgical Oncology, Mayo Clinic Arizona, Phoenix, AZ, USA.
William CaseyDepartment of Surgery, Division of Plastic Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA.
Ryan CranerDepartment of Anesthesiology, Mayo Clinic Arizona, Phoenix, AZ, USA.
Alanna RebeccaDepartment of Surgery, Division of Plastic Surgery, Mayo Clinic Arizona, Phoenix, AZ, USA.
Barbara A PockajDepartment of General Surgery, Division of Surgical Oncology, Mayo Clinic Arizona, Phoenix, AZ, USA. pockaj.barbara@mayo.edu.
Mayo Clinic in Florida · USMayo Clinic Hospital · USMayo Clinic in Arizona · USWinnMed · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEnhanced recovery after surgery (ERAS) protocols following mastectomy with or without implant-based breast reconstruction (IBBR) include ketorolac for multimodal perioperative analgesia. There are concerns that ketorolac could be associated with increased risk of postoperative hematoma formation.

methodsRetrospective review of patients undergoing mastectomy with or without IBBR between January 2013 and December 2019 at a single institution. Patients received 15 mg, 30 mg, or no ketorolac depending on ERAS protocol adherence, patient characteristics, and surgeon preference. Clinically significant hematoma was defined as requiring surgical intervention on day of surgery or postoperative day 1. Patients were compared by demographics, surgical characteristics, ketorolac dose, and hematoma prevalence. Univariable and multivariable logistic regression evaluated hematoma formation odds.

resultsEight hundred patients met inclusion criteria: 477 received ketorolac. Those who received ketorolac were younger, had lower ASA scores, were more likely to have bilateral procedures and undergo concomitant IBBR, had longer operative times, were less likely to take antiplatelet or anticoagulation medications, had higher PACU pain scores, and had higher incidence of hematomas requiring surgical intervention. Of the cohort, 4.4% had clinically significant hematomas. The 15 mg and 30 mg ketorolac groups had similar prevalence (6.0% vs 5.8%, p = 0.95). On univariable regression, there were increased odds of hematoma formation in patients who were younger, had bilateral procedures, had longer OR times, and who received ketorolac. On multivariable regression, none of the prior variables remained significant.

conclusionAfter accounting for associations with longer operative times, concomitant IBBR, and bilateral procedures, ketorolac administration did not remain an independent risk factor for hematoma formation.

Indexed as

Breast NeoplasmsKetorolacAnti-Inflammatory Agents, Non-SteroidalFemaleHematomaHumansMastectomyOutpatientsPostoperative PainRetrospective StudiesAnti-Inflammatory Agents, Non-SteroidalKetorolac

Identifiers

PMID35849298
OpenAlexW4285801766

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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.