Evidence map›Paper›PMID 38035739›Full record

ArticleBMJ open2023

Effect of the COVID-19 pandemic on the care for acute cholecystitis: a Swedish multicentre retrospective cohort study.

Erik Osterman, Sofia Jakobsson, Christina Larsson, Fredrik Linder

Open access · goldAbstract readMulticenter Study
In one paragraph

Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.8field-weighted citation impact, top 23% 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

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
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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 2 institutions in 1 country.

Erik Osterman *CKF Gävleborg, Uppsala University, Gävle, Sweden erik.osterman@igp.uu.se.ORCID 0000-0003-1621-7872
Sofia Jakobsson *Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Christina LarssonDepartment of Surgery, Gävle Sjukhus, Gävle, Sweden.
Fredrik LinderDepartment of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Uppsala University · SEGävle Hospital · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe present study aimed to investigate if and how the panorama of acute cholecystitis changed in 2020 in Sweden. Seven aspects were identified, the incidence of cholecystitis, the Tokyo grade, the timing of diagnosis and treatment, the proportion treated with early surgery, the proportion of patients treated with delayed surgery, and new complications from gallstones.

designRetrospective multicentre cohort study.

setting3 hospitals in Sweden, covering 675 000 inhabitants.

participants1634 patients with cholecystitis. OUTCOMES: The incidence, treatment choice and diagnostic and treatment delay were investigated by comparing prepandemic and pandemic patients.

resultsPatients diagnosed with cholecystitis during the pandemic were more comorbid (American Society of Anesthesiologists 2-5, 86% vs 81%, p=0.01) and more often had a diagnostic CT (67% vs 59%, p=0.01). There were variations in the number of patients corresponding with the pandemic waves, but there was no overall increase in the number of patients with cholecystitis (78 vs 76 cases/100 000 inhabitants, p=0.7) or the proportion of patients treated with surgery during the pandemic (50% vs 50%, p=0.4). There was no increase in time to admission from symptoms (both median 1 day, p=0.7), or surgery from admission (both median 1 day, p=0.9). The proportion of grades 2-3 cholecystitis was not higher during the pandemic (46% vs 44%, p=0.9). The median time to elective surgery increased (184 days vs 130 days, p=0.04), but there was no increase in new gallstone complications (35% vs 39%, p=0.3).

conclusionEmergency surgery for cholecystitis was not impacted by the pandemic in Sweden. Patients were more comorbid but did not have more severe cholecystitis nor was there a delay in seeking care. Fewer patients non-operatively managed had elective surgery within 6 months of their initial diagnosis but there was no corresponding increase in gallstone complications.

Indexed as

Cholecystectomy, LaparoscopicCholecystitisCholecystitis, AcuteCOVID-19GallstonesCohort StudiesHumansPandemicsRetrospective StudiesSwedenCOVID-19Observational StudyRetrospective StudiesSURGERY

Identifiers

PMID38035739
PMCPMC10689379
OpenAlexW4389210744

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LicenceCC BY
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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.