Evidence map›Paper›PMID 36931652›Full record

ArticleCanadian journal of surgery. Journal canadien de chirurgie

Major morbidity and mortality associated with delays to emergent surgery in children: a risk-adjusted analysis.

Sonia Anne Butterworth, Irena Zivkovic, Sandra Kim, Kourosh Afshar

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

Article in Canadian journal of surgery. Journal canadien de chirurgie. 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
2.2field-weighted citation impact, top 11% 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, 10 citations in OpenAlex.

  1. The Utility of Large Language Models to Assist With Emergency Triage Decisions Within Otolaryngology.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2026
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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

4 authors at 3 institutions in 1 country.

Sonia Anne ButterworthFrom the Division of Pediatric Surgery, University of British Columbia, Vancouver, BC (Butterworth); BC Children's Hospital, Vancouver, BC (Butterworth); the Faculty of Medicine, University of British Columbia, Vancouver, BC (Zivkovic); the Department of Urology, Dalhousie University, Halifax, NS; and the Department of Urology, University of British Columbia, BC Children's Hospital, Vancouver, BC (Afshar) sbutterworth@cw.bc.ca.
Irena ZivkovicFrom the Division of Pediatric Surgery, University of British Columbia, Vancouver, BC (Butterworth); BC Children's Hospital, Vancouver, BC (Butterworth); the Faculty of Medicine, University of British Columbia, Vancouver, BC (Zivkovic); the Department of Urology, Dalhousie University, Halifax, NS; and the Department of Urology, University of British Columbia, BC Children's Hospital, Vancouver, BC (Afshar).
Sandra KimFrom the Division of Pediatric Surgery, University of British Columbia, Vancouver, BC (Butterworth); BC Children's Hospital, Vancouver, BC (Butterworth); the Faculty of Medicine, University of British Columbia, Vancouver, BC (Zivkovic); the Department of Urology, Dalhousie University, Halifax, NS; and the Department of Urology, University of British Columbia, BC Children's Hospital, Vancouver, BC (Afshar).
Kourosh AfsharFrom the Division of Pediatric Surgery, University of British Columbia, Vancouver, BC (Butterworth); BC Children's Hospital, Vancouver, BC (Butterworth); the Faculty of Medicine, University of British Columbia, Vancouver, BC (Zivkovic); the Department of Urology, Dalhousie University, Halifax, NS; and the Department of Urology, University of British Columbia, BC Children's Hospital, Vancouver, BC (Afshar).
University of British Columbia · CABC Children's Hospital · CADalhousie University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDelay of emergency surgery contributes to morbidity and mortality, and physiologic status affects outcomes of patients requiring emergent surgery. Our purpose was to determine whether delays to emergent surgery in children were associated with increased major morbidity or mortality in a risk-adjusted population.

methodsWe performed a retrospective review of class 1 (≤ 60 min to operating room) surgical procedures from July 11, 2011, to July 30, 2016, at BC Children's Hospital, Vancouver. Data sources included the operating room database, patient charts, American Society of Anesthesiologists classification, Neonatal Acute Physiology (SNAP II) and Pediatric Risk of Mortality (PRISM III) scores, time from booking to operating room and outcome. Patients were classified as being at low or high risk for death. We defined major morbidity as unintended loss of an organ, limb or function related to surgery, and delay to surgery as more than 60 minutes from booking to in room. We used the χ

resultsThere were 384 cases (367 patients), 223 high-risk and 161 low-risk. The median age was 4 years (range 0 d-18 yr). Overall, 184 cases (47.9%) were delayed. Major morbidity occurred in 94 cases (24.5%), and 28 patients (7.6%) (all in the high-risk group) died. The mean time to the operating room was 1.46 hours for patients with major morbidity/mortality and 1.17 hours for those without. After adjustment for risk level, multivariate analysis showed delay to surgery to be associated with 85% increased odds of morbidity and/or mortality (adjusted odds ratio 1.85, 95% confidence interval 1.20-2.94) compared to no delay.

conclusionDelay to emergent surgery was associated with a significant increase in major morbidity and/or mortality. Children who require emergency surgery need their care prioritized by not only operating room teams but also hospitals and government; otherwise, they will continue to experience unintended consequences.

Indexed as

Surgical Procedures, OperativeTime-to-TreatmentAdolescentChildChild, PreschoolEmergency Service, HospitalHumansInfantInfant, NewbornLogistic ModelsMorbidityMortalityOperating RoomsRetrospective StudiesRisk AssessmentRisk Factors

Identifiers

PMID36931652
PMCPMC10027761
OpenAlexW4327724969

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.