Evidence map›Paper›PMID 37741802›Full record

ArticleAmerican journal of surgery2024

An acute care surgeon's dilemma: Operative vs. non-operative management of emergency general surgery conditions in patients with recent colorectal cancer treatment.

Sara P Ginzberg, Christopher J Wirtalla, Luke J Keele, Heather Wachtel, Elinore J Kaufman, Rachel R Kelz

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Sara P GinzbergDepartment of Surgery, University of Pennsylvania Health System, Philadelphia, PA, USA; Abramson Cancer Center, University of Pennsylvania Health System, Philadelphia, PA, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA. Electronic address: sara.ginzberg@pennmedicine.upenn.edu.
Christopher J WirtallaDepartment of Surgery, University of Pennsylvania Health System, Philadelphia, PA, USA.
Luke J KeeleDepartment of Surgery, University of Pennsylvania Health System, Philadelphia, PA, USA.
Heather WachtelDepartment of Surgery, University of Pennsylvania Health System, Philadelphia, PA, USA; Abramson Cancer Center, University of Pennsylvania Health System, Philadelphia, PA, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Elinore J KaufmanDepartment of Surgery, University of Pennsylvania Health System, Philadelphia, PA, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Rachel R KelzDepartment of Surgery, University of Pennsylvania Health System, Philadelphia, PA, USA; Abramson Cancer Center, University of Pennsylvania Health System, Philadelphia, PA, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

Funding

Using Outcomes to Guide Treatment of Surgical EmergenciesR01AG060612 · NIA · UNIVERSITY OF PENNSYLVANIA · PI KELZ, RACHEL · 2019 to 2023
$2.7M
NIA NIH HHS R01 AG060612
6 · The paper itself

Abstract

backgroundThis comparative effectiveness study examined outcomes of operative vs. non-operative management for emergency general surgery (EGS) conditions in patients with recent cancer treatment (RT).

methodsMedicare beneficiaries with a history of colorectal cancer hospitalized for an EGS condition (2016-2018) were identified. RT was defined as chemotherapy/radiation within 3 months prior to admission. Instrumental variable analysis assessed the impact of management on mortality and readmissions among survivors (30d, 60d, and 90d), for patients in whom there was clinical equipoise regarding optimal management strategy.

resultsOf 26,097 patients, 13% had undergone RT. In both the RT and non-RT groups, the optimal management strategy was uncertain in 14%. Operative management conferred increased risk of mortality but not readmission in patients with RT compared to those without (90d mortality:+43%, p ​= ​0.03; 90d readmission:+7.1%, p ​= ​0.776).

conclusionsIn patients with RT for whom there is clinical equipoise regarding EGS management, operative intervention increases risk of mortality.

Indexed as

Colorectal NeoplasmsGeneral SurgerySurgeonsSurgical Procedures, OperativeAcute Care SurgeryAgedHospitalizationHumansMedicareRetrospective StudiesUnited StatesCausal inferenceColon cancerEmergency surgeryGastrointestinal neoplasmsInstrumental variableRectal cancer

Identifiers

PMID37741802
PMCPMC10841180

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Registered trials

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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.