Evidence map›Paper›PMID 36478280›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2023

Revisiting abdominal closure in mesenteric ischemia: is there an association with outcome?

Jefferson A Proaño-Zamudio, Dias Argandykov, Angela Renne, Anthony Gebran, Ander Dorken-Gallastegi, Charudutt N Paranjape, Haytham M A Kaafarani, David R King, George C Velmahos, John O Hwabejire

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In one paragraph

Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.5field-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

5 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Review
  3. Review
  4. Acute mesenteric ischemia: diagnostic and therapeutic challenges.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023
    Article
  5. Acute mesenteric ischaemia.The British journal of surgery · 2023
    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

10 authors at 1 institution in 1 country.

Jefferson A Proaño-ZamudioDivision of Trauma, Emergency Surgery and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, 165 Cambridge St, Suite 810, Boston, MA, 02114, USA.
Dias ArgandykovDivision of Trauma, Emergency Surgery and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, 165 Cambridge St, Suite 810, Boston, MA, 02114, USA.
Angela RenneDivision of Trauma, Emergency Surgery and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, 165 Cambridge St, Suite 810, Boston, MA, 02114, USA.
Anthony GebranDivision of Trauma, Emergency Surgery and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, 165 Cambridge St, Suite 810, Boston, MA, 02114, USA.
Ander Dorken-GallastegiDivision of Trauma, Emergency Surgery and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, 165 Cambridge St, Suite 810, Boston, MA, 02114, USA.
Charudutt N ParanjapeDivision of Trauma, Emergency Surgery and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, 165 Cambridge St, Suite 810, Boston, MA, 02114, USA.
Haytham M A KaafaraniDivision of Trauma, Emergency Surgery and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, 165 Cambridge St, Suite 810, Boston, MA, 02114, USA.
David R KingDivision of Trauma, Emergency Surgery and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, 165 Cambridge St, Suite 810, Boston, MA, 02114, USA.
George C VelmahosDivision of Trauma, Emergency Surgery and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, 165 Cambridge St, Suite 810, Boston, MA, 02114, USA.
John O HwabejireDivision of Trauma, Emergency Surgery and Surgical Critical Care, Department of Surgery, Massachusetts General Hospital, 165 Cambridge St, Suite 810, Boston, MA, 02114, USA. jhwabejire@partners.org.ORCID http://orcid.org/0000-0003-0759-2638
Massachusetts General Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeCurrent guidelines advocate liberal use of delayed abdominal closure in patients with acute mesenteric ischemia (AMI) undergoing laparotomy. Few studies have systematically examined this practice. The goal of this study was to evaluate the effect of delayed abdominal closure on postoperative morbidity and mortality in patients with AMI.

methodsWe performed a retrospective cohort study of the ACS-NSQIP 2013-2017 registry. We included patients with a diagnosis of AMI undergoing emergency laparotomy. Patients were divided into two groups based on the type of abdominal closure: (1) delayed fascial closure (DFC) when no layers of the abdominal wall were closed and (2) immediate fascial closure (IFC) if deep layers or all layers of the abdominal wall were closed. Propensity score matching was performed based on comorbidities, pre-operative, and operative characteristics. Univariable analysis was performed on the matched sample.

resultsThe propensity-matched cohort consisted of 1520 patients equally divided into the DFC and IFC groups. The median (IQR) age was 68 (59-77), and 836 (55.0%) were female. Compared to IFC, the DFC group showed increased in-hospital mortality (38.9% vs. 31.6%, p = 0.002), 30-day mortality (42.4% vs. 36.3%, p = 0.012), and increased risk of respiratory failure (59.5% vs. 31.2%, p < 0.001).

conclusionsThe delayed fascial closure technique was associated with increased mortality compared to immediate fascial closure. These findings do not support the blanket incorporation of delayed closure in mesenteric ischemia care or its previously advocated liberal use.

Indexed as

Abdominal InjuriesAbdominal WallMesenteric IschemiaFasciaFasciotomyFemaleHumansLaparotomyMaleRetrospective StudiesTreatment OutcomeEmergency general surgeryMesenteric ischemiaNSQIPOpen abdomen

Identifiers

PMID36478280
OpenAlexW4310940716

What OpenQuestion holds

Textmetadata
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.