Evidence map›Paper›PMID 38182799›Full record

ArticleSurgical endoscopy2024

Perforated peptic ulcer disease in transferred patients is associated with significant increase in length of stay.

R Schneider, Richard Perugini, S Karthikeyan, O Okereke, D M Herscovici, A Richard, T Doan, L Suh, James E Carroll

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In one paragraph

Article in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

R SchneiderDepartment of Surgery, University of Massachusetts Chan School of Medicine, Rachel Schneider, 514 Plantation Street, Worcester, MA, 01605, USA. Rachel.Schneider@umassmed.edu.ORCID 0009-0008-8973-4786
Richard PeruginiDepartment of Surgery, University of Massachusetts Chan School of Medicine, Rachel Schneider, 514 Plantation Street, Worcester, MA, 01605, USA.
S KarthikeyanDepartment of Surgery, University of Massachusetts Chan School of Medicine, Rachel Schneider, 514 Plantation Street, Worcester, MA, 01605, USA.
O OkerekeDepartment of Surgery, University of Massachusetts Chan School of Medicine, Rachel Schneider, 514 Plantation Street, Worcester, MA, 01605, USA.
D M HerscoviciDepartment of Surgery, University of Massachusetts Chan School of Medicine, Rachel Schneider, 514 Plantation Street, Worcester, MA, 01605, USA.
A RichardDepartment of Surgery, University of Massachusetts Chan School of Medicine, Rachel Schneider, 514 Plantation Street, Worcester, MA, 01605, USA.
T DoanDepartment of Surgery, University of Massachusetts Chan School of Medicine, Rachel Schneider, 514 Plantation Street, Worcester, MA, 01605, USA.
L SuhDepartment of Surgery, University of Massachusetts Chan School of Medicine, Rachel Schneider, 514 Plantation Street, Worcester, MA, 01605, USA.
James E CarrollDepartment of Surgery, University of Massachusetts Chan School of Medicine, Rachel Schneider, 514 Plantation Street, Worcester, MA, 01605, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPerforated peptic ulcer disease (PPUD) has a prevalence of 0.004-0.014% with mortality of 23.5% (Tarasconi et al. in World J Emerg Surg 15(PG-3):3, 2020). In this single center study, we examined the impact associated with patient transfer from outside facilities to our center for definitive surgical intervention (exploratory laparotomy).

methodsUsing EPIC report workbench, we identified 27 patients between 2018 and 2021 undergoing exploratory laparotomy with a concurrent diagnosis of peptic ulcer disease, nine of which were transferred to our institution for care. We queried this population for markers of disease severity including mortality, length of stay, intensive care unit (ICU) length of stay, and readmission rates. Manual chart reviews were performed to examine these outcomes in more detail and identify patients who had been transferred to our facility for surgery from an outside hospital.

resultsA total of 27 patients were identified undergoing exploratory laparotomy for definitive treatment of PPUD. The majority of patients queried underwent level A operations, the most urgent level of activation. In our institution, a Level A operation needs to go to the operating room within one hour of arrival to the hospital. Average mortality for this patient population was 14.8%. The readmission rate was 40.1%, and average length of ICU stay post-operatively was 16 days, with 83% of non-transfer patients requiring ICU admission and 100% of transfer patients requiring ICU admission, although this was not found to be statistically significant. Average length of hospital stay was 27 days overall. For non-transfer patients and transfer patients, LOS was 20 days and 41 days, respectively, which was statistically significant by one-sided t-test (p = 0.05).

conclusionPatients transferred for definitive care of PPUD in a population otherwise notable for high mortality and high readmission rates: their average length of stay compared to non-transfer patients was over twice the length, which was statistically significant. Transferred patients also had higher rates of ICU care requirement although this was not statistically significant. Further inquiry to identify modifiable variables to facilitate the care of transferred patients is warranted, especially in the context of improving quality metrics known to enhance patient outcomes, satisfaction, and value.

Indexed as

Peptic UlcerPeptic Ulcer PerforationHumansIntensive Care UnitsLaparotomyLength of StayRetrospective StudiesEPIC reportLength of stayPerforated peptic ulcer diseaseRetrospective cohortTransfer

Identifiers

PMID38182799

What OpenQuestion holds

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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.