Evidence map›Paper›PMID 39666031›Full record

ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2024

Surgical treatment of neonatal brachial plexus palsy: A cohort study using the Pediatric Health Information System (PHIS) database.

Molly F MacIsaac, Joshua M Wright, Nicole K Le, Lee G Phillips, Allan J Belzberg, S Alex Rottgers, Jordan N Halsey

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In one paragraph

Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–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 synthesis or guideline pooled it.

  1. Pooled it
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

7 authors.

Molly F MacIsaacDivision of Plastic and Reconstructive Surgery, Johns Hopkins All Children's Hospital, 601 Fifth Street South, Suite 611, St. Petersburg, FL, USA.
Joshua M WrightDivision of Plastic and Reconstructive Surgery, Johns Hopkins All Children's Hospital, 601 Fifth Street South, Suite 611, St. Petersburg, FL, USA.
Nicole K LeDepartment of Plastic Surgery, University of South Florida, Tampa, FL, USA.
Lee G PhillipsDepartment of Orthopedic Surgery, Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA.
Allan J BelzbergDepartment of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
S Alex RottgersDivision of Plastic and Reconstructive Surgery, Johns Hopkins All Children's Hospital, 601 Fifth Street South, Suite 611, St. Petersburg, FL, USA.
Jordan N HalseyDivision of Plastic and Reconstructive Surgery, Johns Hopkins All Children's Hospital, 601 Fifth Street South, Suite 611, St. Petersburg, FL, USA. jhalsey2@jhmi.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThis study aims to explore demographic disparities, regional and institutional variations, surgical timing, narcotic use, and management trends in neonatal brachial plexus palsy (NBPP) patients due to limited published literature.

methodsWe conducted a retrospective cohort study using the Pediatric Health Information System (PHIS) database of NBPP patients who underwent surgery within the first 2 years of life. Patients were stratified into two groups based on age at surgery: ≤ 8 months and > 8 months.

resultsA total of 788 patients were identified, with a mean surgical age of 8.1 months. Black patients were disproportionately affected (29%), over twice their national birth rate (14%). Narcotic use was more common in younger patients (63% vs. 53%, p = 0.003), as well as in those treated in the West (71%, p = 0.001) and Northeast (73%, p = 0.004), and by plastic (74%, p < 0.0001) or orthopedic surgeons (69%, p = 0.002). Patients prescribed narcotics had longer hospital stays (1.7 vs. 1.2 days, p < 0.0001) and higher complication rates (7.9% vs. 3.1%, p = 0.009). Narcotic use decreased significantly over the study period (p = 0.002). Short-term outcomes, including complication and readmission rates, were similar across the three primary surgical specialties (plastic, orthopedic, and neurosurgery). High-volume centers had lower complication rates (1.5% vs. 5.4%, p = 0.002) and ICU admissions (5.8% vs. 18%, p < 0.0001) compared to medium-volume centers.

conclusionWhile narcotic use was associated with longer stays and complications, short-term outcomes were consistent across specialties. Standardized care protocols may help improve patient outcomes.

Indexed as

Databases, FactualHealth Information SystemsNeonatal Brachial Plexus PalsyChild, PreschoolCohort StudiesFemaleHumansInfantInfant, NewbornMaleNeurosurgical ProceduresRetrospective StudiesNarcotic useOperative managementPost-operative complicationsRacial disparitiesRegional variationsSurgical timing

Identifiers

PMID39666031

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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.