Evidence map›Paper›PMID 39837678›Full record

ArticleJournal of pediatric surgery2025

Navigating Limited Resources-Outpatient Pediatric Cholecystectomies at Rural Hospitals.

Erin C Howell, Rie Sakai-Bizmark, Shannon Richardson, Youngju Pak, Steven L Lee, Daniel A DeUgarte

Abstract read
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Article in Journal of pediatric surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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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

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

6 authors.

Erin C HowellDepartment of Surgery, University of New Mexico School of Medicine, 2211 Lomas Blvd NE, Albuquerque, NM 87106, USA; Department of Surgery, Harbor-UCLA Medical Center, 1000 W. Carson Street, Box 42, Torrance, CA 90502, USA. Electronic address: echowell@salud.unm.edu.
Rie Sakai-BizmarkThe Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 W. Carson Street, Torrance, CA 90502, USA; Department of Pediatrics, Harbor-UCLA Medical Center, 1000 W. Carson Street, Torrance, CA 90502, USA; David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA. Electronic address: rsakaibizmark@lundquist.org.
Shannon RichardsonDavid Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA. Electronic address: scrichardson@mednet.ucla.edu.
Youngju PakThe Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, 1124 W. Carson Street, Torrance, CA 90502, USA. Electronic address: ypak@lundquist.org.
Steven L LeeDivision of Pediatric Surgery, University of Washington School of Medicine and Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA 98105, USA. Electronic address: steven.lee@seattlechildrens.org.
Daniel A DeUgarteDepartment of Surgery, Harbor-UCLA Medical Center, 1000 W. Carson Street, Box 42, Torrance, CA 90502, USA; Division of Pediatric Surgery, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 77-123 CHS, Los Angeles, CA 90095, USA. Electronic address: ddeugarte@mednet.ucla.edu.

Funding

UCLA Clinical Translational Science InstituteUL1TR001881 · NCATS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI ARLEEN F. BROWN, ARASH NAEIM · 2016 to 2026
$118.1M
Newborn Screening for Critical Congenital Heart Disease in U.S.: Assessment of implementation obstacles and application of cost-effectiveness to gauge if action needed for improved implementationK01HL141697 · NHLBI · LUNDQUIST INSTITUTE FOR BIOMEDICAL INNOVATION AT HARBOR-UCLA MEDICAL CENTER · PI SAKAI-BIZMARK, RIE · 2018 to 2022
$688k
NCATS NIH HHS UL1 TR001881NHLBI NIH HHS K01 HL141697
6 · The paper itself

Abstract

backgroundRural facilities that provide pediatric surgical services are a critical resource to local communities. Our aim was to characterize differences in outpatient pediatric cholecystectomy outcomes performed at rural and urban hospitals with the hypothesis that rural hospitals would have similar outcomes.

methodsThe Nationwide Ambulatory Surgery Sample (NASS), which contains ambulatory surgery encounters at hospital-owned facilities, was used to perform a retrospective cohort analysis of pediatric patients age 18-years and younger who had a cholecystectomy (n = 15,449) between 2016 and 2018. Survey-weighted multivariate regression analyses were used to evaluate the association of rural and urban hospital locations with the primary outcome of routine discharge. Models were adjusted for sex, age, comorbidities, insurance, income quartile, indication for operation, and hospital characteristics.

resultsPatients receiving care at rural hospitals were more commonly in the lowest two median income quartiles compared to urban hospitals (91.1 % versus 58.2 %, p < 0.01) and had more complex chronic comorbidities (63.1 % versus 57.2 %, p < 0.01). In both settings, the most common surgical indication was cholecystitis followed by biliary dyskinesia; nearly all procedures were performed laparoscopically (>99 %), and complications were rare with no deaths. Survey weight multivariate regression analysis showed patients cared for at rural hospitals had a higher odds ratio of routine discharge compared to those cared for at urban hospitals (adjusted OR 2.27, 95 %CI 1.04-4.99, p = 0.04).

conclusionsPediatric patients at rural hospitals have lower median income and a higher mean morbidity index. Despite these challenges, outpatient cholecystectomy was safe at rural hospitals and associated with increased odds of routine discharge when compared with urban hospitals.

Indexed as

Ambulatory Surgical ProceduresCholecystectomyHospitals, RuralHospitals, UrbanAdolescentChildChild, PreschoolFemaleHumansInfantMaleRetrospective StudiesUnited StatesElectiveLaparoscopic cholecystectomyPediatric surgeryRural

Identifiers

PMID39837678
PMCPMC12119231

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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.