Evidence map›Paper›PMID 41197586›Full record

ArticleThe Journal of surgical research2025

Quick Cuts: Surgeon Tendency to Operate in Emergency General Surgery.

Rachael C Acker, Jacob Walker Rosenthal, Jasmine Hwang, James E Sharpe, Elinore Kaufman, Heather Wachtel, Giorgos Karakousis, Rachel R Kelz

Abstract read
In one paragraph

Article in The Journal of surgical research, 2025. 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

8 authors.

Rachael C AckerDepartment of Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: rachael.acker@pennmedicine.upenn.edu.
Jacob Walker RosenthalDepartment of Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania.
Jasmine HwangDepartment of Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
James E SharpeDepartment of Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania.
Elinore KaufmanDepartment of Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Heather WachtelDepartment of Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Giorgos KarakousisDepartment of Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Rachel R KelzDepartment of Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.

Funding

A genotype-phenotype study of germline succinate dehydrogenase pathogenic variantsK08CA270385 · NCI · UNIVERSITY OF PENNSYLVANIA · PI Heather Wachtel · 2022 to 2026
$967k
NCI NIH HHS K08 CA270385
6 · The paper itself

Abstract

introductionIndividual surgeons have different practice patterns. The extent of variation across surgeons in the use of operative and nonoperative treatment remains unknown. This study examines differences in the use of operative treatment for emergency general surgery (EGS) conditions at the surgeon level.

methodsPatients aged ≥18 y hospitalized for EGS conditions were identified in the Healthcare Cost and Utilization Project State Inpatient Database (2016-2020) in FL/MD/NV using International Classification of Diseases, Tenth Revision codes. Tendency to operate (TTO = number of operations performed/number of patients treated) was calculated at the surgeon level for all EGS conditions and for complicated diverticulitis and cholecystitis. Differences in surgeon practice and patient attributes by the lowest and highest surgeon TTO quartiles were examined.

resultsOverall, 1884 surgeons treated 347,589 patients with EGS conditions. Median surgeon TTO was 59% [interquartile interval: 44%, 68%] for all EGS conditions. Median surgeon TTO was 44% [25%, 59%] for complicated diverticulitis and 74% [66%, 81%] for cholecystitis. Low-TTO surgeons treated fewer EGS patients per year than high-TTO surgeons (median 23 versus 41, P < 0.001). Of note, the total number of inpatients (EGS and non-EGS) treated per surgeon per year was similar between low- and high-TTO surgeons (103 versus 104 patients, P < 0.001).

conclusionsThe use of operative treatment for common EGS conditions depends, in part, on the surgeon that each patient is randomly assigned. Moreover, many EGS conditions are managed nonoperatively by surgeons. Surgeons should be compensated for the totality of their expertise.

Indexed as

Emergency TreatmentGeneral SurgeryPractice Patterns, Physicians'SurgeonsSurgical Procedures, OperativeAcute Care SurgeryAdultAgedCholecystitisFemaleHumansMaleMiddle AgedRetrospective StudiesEmergency general surgeryPractice patternsPreference for operative treatmentScope of practiceSurgical decision-makingTendency to operate

Identifiers

PMID41197586
PMCPMC13276718

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.