| Title |
Do Drains Contribute to Pancreatic Fistulae? Analysis of over 5000 Pancreatectomy Patients
|
|---|---|
| Published in |
Journal of Gastrointestinal Surgery, February 2018
|
| DOI | 10.1007/s11605-018-3702-4 |
| Pubmed ID | |
| Authors |
R. El Khoury, C. Kabir, V.K. Maker, M Banulescu, M. Wasserman, A.V. Maker |
| Abstract |
Conflicting evidence exists from randomized controlled trials supporting both increased complications/fistulae and improved outcomes with drain placement after pancreatectomy. The objective was to determine drain practice patterns in the USA, and to identify if drain placement was associated with fistula formation. Demographic, perioperative, and patient outcome data were captured from the most recent annual NSQIP pancreatic demonstration project database, including components of the fistula risk score. Significant variables in univariate analysis were entered into adjusted logistic regression models. Of 5013 pancreatectomy patients, 4343 (87%) underwent drain placement and 18% of patients experienced a pancreatic fistula. When controlled for other factors, drain placement was associated with ducts < 3 mm, soft glands, and blood transfusion within 72 h of surgery. Age, obesity, neoadjuvant radiation, preoperative INR level, and malignant histology lost significance in the adjusted model. Drained patients experienced higher readmission rates (17 vs. 14%; p < 0.05) and increased (20 vs. 8%; p < 0.01) pancreatic fistulae. Fistula was associated with obesity, no neoadjuvant chemotherapy, drain placement, < 3 mm duct diameter, soft gland, and longer operative times. Drain placement remained independently associated with fistula after both distal pancreatectomy (OR = 2.84 (1.70, 4.75); p < 0.01) and pancreatoduodenectomy (OR = 2.29 (1.28, 4.11); p < 0.01). Despite randomized controlled clinical trial data supporting no drain placement, drains are currently placed in the vast majority (87%) of pancreatectomy patients from > 100 institutions in the USA, particularly those with soft glands, small ducts, and perioperative blood transfusions. When these factors are controlled for, drain placement remains independently associated with fistulae after both distal and proximal pancreatectomy. |
X Demographics
The data shown below were collected from the profiles of 39 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 10 | 26% |
| Mexico | 7 | 18% |
| Spain | 6 | 15% |
| Brazil | 1 | 3% |
| Portugal | 1 | 3% |
| Uruguay | 1 | 3% |
| Panama | 1 | 3% |
| United Kingdom | 1 | 3% |
| India | 1 | 3% |
| Other | 0 | 0% |
| Unknown | 10 | 26% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 23 | 59% |
| Practitioners (doctors, other healthcare professionals) | 12 | 31% |
| Scientists | 3 | 8% |
| Science communicators (journalists, bloggers, editors) | 1 | 3% |
Mendeley readers
The data shown below were compiled from readership statistics for 39 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 39 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 5 | 13% |
| Student > Postgraduate | 5 | 13% |
| Researcher | 5 | 13% |
| Student > Master | 3 | 8% |
| Professor | 2 | 5% |
| Other | 3 | 8% |
| Unknown | 16 | 41% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 18 | 46% |
| Biochemistry, Genetics and Molecular Biology | 2 | 5% |
| Nursing and Health Professions | 1 | 3% |
| Psychology | 1 | 3% |
| Agricultural and Biological Sciences | 1 | 3% |
| Other | 0 | 0% |
| Unknown | 16 | 41% |
Attention Score in Context
This research output has an Altmetric Attention Score of 24. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 25 April 2018.
All research outputs
#1,586,285
of 25,394,764 outputs
Outputs from Journal of Gastrointestinal Surgery
#38
of 2,489 outputs
Outputs of similar age
#37,978
of 454,542 outputs
Outputs of similar age from Journal of Gastrointestinal Surgery
#2
of 41 outputs
Altmetric has tracked 25,394,764 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 93rd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,489 research outputs from this source. They receive a mean Attention Score of 4.0. This one has done particularly well, scoring higher than 98% of its peers.
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We're also able to compare this research output to 41 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 95% of its contemporaries.