Evidence map›Paper›PMID 37563342›Full record

ArticleSurgical endoscopy2023

Is the Hartmann's procedure for diverticulitis obsolete? National trends in colectomy for diverticulitis in the emergency setting from 1993 to 2018.

Hatim A AlSulaim, Richard Garfinkle, Daniel Marinescu, Nancy Morin, Gabriela A Ghitulescu, Carol-Ann Vasilevsky, Julio Faria, Allison Pang, Marylise Boutros

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2023. 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
2.5field-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

4 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. Contemporary management of diverticulitis.Surgery open science · 2024
    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

9 authors at 3 institutions in 2 countries.

Hatim A AlSulaimDivision of Colon and Rectal Surgery, Jewish General Hospital, Montreal, QC, Canada.
Richard GarfinkleDivision of Colon and Rectal Surgery, Jewish General Hospital, Montreal, QC, Canada.
Daniel MarinescuDivision of Colon and Rectal Surgery, Jewish General Hospital, Montreal, QC, Canada.
Nancy MorinDivision of Colon and Rectal Surgery, Jewish General Hospital, Montreal, QC, Canada.
Gabriela A GhitulescuDivision of Colon and Rectal Surgery, Jewish General Hospital, Montreal, QC, Canada.
Carol-Ann VasilevskyDivision of Colon and Rectal Surgery, Jewish General Hospital, Montreal, QC, Canada.
Julio FariaDivision of Colon and Rectal Surgery, Jewish General Hospital, Montreal, QC, Canada.
Allison PangDivision of Colon and Rectal Surgery, Jewish General Hospital, Montreal, QC, Canada.
Marylise BoutrosDivision of Colon and Rectal Surgery, Jewish General Hospital, Montreal, QC, Canada. marylise.boutros@mcgill.ca.ORCID http://orcid.org/0000-0001-8006-321X
Jewish General Hospital · CAMcGill University Health Centre · CAQassim University · SA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHistorically, Hartmann's procedure (HP) has been the operation of choice for diverticulitis in the emergency setting. However, recent evidence has demonstrated the safety of primary anastomosis (PA) with or without diverting ileostomy. The purpose of this study was to evaluate the trends of, and factors associated with, HP compared to PA in emergency surgery for diverticulitis over 25 years.

methodsUsing the National Inpatient Sample database, we identified adult patients ≥ 18 years old who underwent emergency surgery for diverticulitis (HP or PA) between 1993 and 2018 using ICD-9 and ICD-10 codes. Patients with inflammatory bowel disease, gastrointestinal cancer or who underwent elective diverticulitis surgery were excluded. Trends in HP were analyzed using multivariable linear regression, and factors associated with HP were assessed with multiple logistic regression.

resultsOf 499,433 patients who underwent colectomy in the emergency setting for acute diverticulitis, 271,288 (54.3%) had a HP and 228,145 (45.7%) had a PA. Median age was 61 years (IQR: 50-73), 53% were women, and 70.5% were white. The proportion of HP slightly increased over the study period-HP comprised 52.6% of included cases in 1993-98 and 55.2% of cases in 2014-2018 (p = 0.017). Advanced age (reference = 18-44 years; 45-54 years: OR 1.16, 95% CI 1.10-1.22; 55-64 years: OR 1.26, 95% CI 1.20-1.33; 65-74 years: OR 1.33, 95% CI 1.25-1.42; ≥ 75 years: OR 1.51, 95% CI 1.41-1.62), complicated diverticulitis (OR 1.41, 95% CI 1.36-1.46), and severity of illness (reference = minor; moderate: OR 1.46, 95% CI 1.38-1.54; major/extreme: OR 3.43, 95% CI 3.25-3.63) were associated with increased odds of HP.

conclusionsOver a 26-year period, HP has remained the most performed procedure in the emergency setting for diverticulitis. Future work should focus on knowledge translation with a possible change in practice as more randomized controlled trials provide support for PA.

Indexed as

DiverticulitisDiverticulitis, ColonicIntestinal PerforationAdolescentAdultAnastomosis, SurgicalColectomyColostomyFemaleHumansMaleMiddle AgedTreatment OutcomeYoung AdultColostomyDiverticulitisHartmann’s procedurePrimary anastomosisTrends

Identifiers

PMID37563342
OpenAlexW4385725376

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.