Evidence map›Paper›PMID 39499434›Full record

ArticleJournal of robotic surgery2024

Subcutaneous emphysema in patients undergoing robotic cardiac surgery: risk factors and clinical outcome.

Martin Winter, Thomas E Rubino, Danielle Miller, Gabin Yun, Keith Dufendach, Nicholas Hess, Sarah Yousef, Ernest Chan, Veronica Garvia Bianchini, Christina Thorngren and 5 more

Abstract read
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In one paragraph

Article in Journal of robotic 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

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

15 authors.

Martin WinterDepartment of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, UPMC Heart and Vascular Institute, 200 Lothrop Street C-718, Pittsburgh, PA, 15123, USA.
Thomas E RubinoDepartment of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, UPMC Heart and Vascular Institute, 200 Lothrop Street C-718, Pittsburgh, PA, 15123, USA.
Danielle MillerDepartment of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, UPMC Heart and Vascular Institute, 200 Lothrop Street C-718, Pittsburgh, PA, 15123, USA.
Gabin YunDepartment of Radiology, University of Pittsburgh School of Medicine, UPMC Heart and Vascular Institute, Pittsburgh, PA, USA.
Keith DufendachDepartment of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, UPMC Heart and Vascular Institute, 200 Lothrop Street C-718, Pittsburgh, PA, 15123, USA.
Nicholas HessDepartment of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, UPMC Heart and Vascular Institute, 200 Lothrop Street C-718, Pittsburgh, PA, 15123, USA.
Sarah YousefDepartment of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, UPMC Heart and Vascular Institute, 200 Lothrop Street C-718, Pittsburgh, PA, 15123, USA.
Ernest ChanDepartment of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, UPMC Heart and Vascular Institute, 200 Lothrop Street C-718, Pittsburgh, PA, 15123, USA.
Veronica Garvia BianchiniDepartment of Critical Care Medicine, University of Pittsburgh School of Medicine, UPMC Heart and Vascular Institute, Pittsburgh, PA, USA.
Christina ThorngrenDepartment of Critical Care Medicine, University of Pittsburgh School of Medicine, UPMC Heart and Vascular Institute, Pittsburgh, PA, USA.
Holt MurrayDepartment of Critical Care Medicine, University of Pittsburgh School of Medicine, UPMC Heart and Vascular Institute, Pittsburgh, PA, USA.
Stephen WaterfordDepartment of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, UPMC Heart and Vascular Institute, 200 Lothrop Street C-718, Pittsburgh, PA, 15123, USA.
David KaczorowskiDepartment of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, UPMC Heart and Vascular Institute, 200 Lothrop Street C-718, Pittsburgh, PA, 15123, USA.
Ibrahim SultanDepartment of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, UPMC Heart and Vascular Institute, 200 Lothrop Street C-718, Pittsburgh, PA, 15123, USA.
Johannes BonattiDepartment of Cardiothoracic Surgery, University of Pittsburgh School of Medicine, UPMC Heart and Vascular Institute, 200 Lothrop Street C-718, Pittsburgh, PA, 15123, USA. bonattijo@upmc.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Little is known about the incidence of subcutaneous emphysema (SE) after robotic cardiac surgery. The aim of this study was to describe the incidence, identify risk factors, and assess its influence on postoperative outcomes. Patients undergoing robotic mitral valve repair (n = 63, 54.3%), robotic minimally invasive direct coronary artery bypass grafting (n = 23, 19.8%), and robotic totally endoscopic coronary artery bypass grafting (n = 30,25.9%) were included in the analysis (total n = 116). Subcutaneous emphysema occurred in 53/116 patients (45.7%). It was mild in 30/53 patients (56.6%), moderate in one patient (1.9%), and severe in 22/53 patients (41.5%). Low body weight (p = 0.009), low BMI (p = 0.006), small body surface area (p = 0.01), and older age (p = 0.041) significantly correlated with SE. Patients undergoing robotic mitral valve repair were affected more often than patients undergoing robotic coronary artery bypass grafting (p = 0.04). Severe subcutaneous emphysema resulted in an increased need for CT-chest imaging (p = 0.026), and additional chest tubes (p = 0.029). Severe emphysema was highly associated with pneumothorax (p < 0.001) and increased duration of chest tube drainage (p = 0.003). Subcutaneous emphysema after robotic heart surgery occurs preferentially in patients with low body weight, low BMI, a small body surface area, and older age and is more common in robotic MVR than in robotic coronary artery bypass surgery. It leads to an increased need for thoracic imaging and additional chest tube insertion. Clinical outcomes are not affected.

Indexed as

Cardiac Surgical ProceduresCoronary Artery BypassPostoperative ComplicationsRobotic Surgical ProceduresSubcutaneous EmphysemaAgedAge FactorsBody Mass IndexChest TubesFemaleHumansIncidenceMaleMiddle AgedMitral ValveRisk FactorsIntensive careMinimally invasive cardiac surgeryPostoperative careRobotic cardiac surgerySubcutaneous emphysema

Identifiers

PMID39499434

What OpenQuestion holds

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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.