| Title |
Comparative Effectiveness and Risks of Bowel Preparation Before Elective Colorectal Surgery
|
|---|---|
| Published in |
Annals of Surgery, April 2018
|
| DOI | 10.1097/sla.0000000000002159 |
| Pubmed ID | |
| Authors |
Sarah E Koller, Katherine W Bauer, Brian L Egleston, Radhika Smith, Matthew M Philp, Howard M Ross, Nestor F Esnaola |
| Abstract |
The objective of this study was to determine the relationship between bowel preparation and surgical site infections (SSIs), and also other postoperative complications, after elective colorectal surgery. SSI is a major source of postoperative morbidity/costs after colorectal surgery. The value of preoperative bowel preparation to prevent SSI remains controversial. We analyzed 32,359 patients who underwent elective colorectal resections in the American College of Surgeons National Surgery Quality Improvement Program database from 2012 to 2014. Univariable and multivariable analyses were performed; propensity adjustment using patient/procedure characteristics was used to account for nonrandom receipt of bowel preparation. 26.7%, 36.6%, 3.8%, and 32.9% of patients received no bowel preparation, mechanical bowel preparation (MBP), oral antibiotics (OA), and MBP + OA, respectively. After propensity adjustment, MBP was not associated with decreased risk of SSI compared with no bowel preparation. In contrast, both OA and OA + MBP were associated with decreased risk of any SSI (adjusted odds ratio 0.49, 95% confidence interval 0.38-0.64; and adjusted odds ratio 0.45, 95% confidence interval 0.40-0.50, respectively) compared with no bowel preparation. OA and MBP + OA were associated with decreased risks of anastomotic leak, postoperative ileus, readmission, and also shorter length of stay (all P < 0.05). Bowel preparation was not associated with increased risk of cardiac/renal complications compared with no preparation. The use of MBP alone before elective colorectal resection to prevent SSI is ineffective and should be abandoned. In contrast, OA and MBP + OA are associated with decreased risks of SSI and are not associated with increased risks of other adverse outcomes compared with no preparation. Prospective studies to determine the efficacy of OA are warranted; in the interim, MBP + OA should be used routinely before elective colorectal resection to prevent SSI. |
X Demographics
The data shown below were collected from the profiles of 33 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 8 | 24% |
| United States | 5 | 15% |
| United Kingdom | 3 | 9% |
| Saudi Arabia | 1 | 3% |
| United Arab Emirates | 1 | 3% |
| India | 1 | 3% |
| Brazil | 1 | 3% |
| South Sudan | 1 | 3% |
| Egypt | 1 | 3% |
| Other | 0 | 0% |
| Unknown | 11 | 33% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 17 | 52% |
| Practitioners (doctors, other healthcare professionals) | 13 | 39% |
| Scientists | 3 | 9% |
Mendeley readers
The data shown below were compiled from readership statistics for 108 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 108 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 19 | 18% |
| Researcher | 15 | 14% |
| Student > Master | 10 | 9% |
| Student > Bachelor | 9 | 8% |
| Student > Doctoral Student | 8 | 7% |
| Other | 23 | 21% |
| Unknown | 24 | 22% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 64 | 59% |
| Nursing and Health Professions | 5 | 5% |
| Business, Management and Accounting | 2 | 2% |
| Immunology and Microbiology | 2 | 2% |
| Agricultural and Biological Sciences | 1 | <1% |
| Other | 3 | 3% |
| Unknown | 31 | 29% |
Attention Score in Context
This research output has an Altmetric Attention Score of 35. 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 05 April 2019.
All research outputs
#1,165,615
of 25,837,817 outputs
Outputs from Annals of Surgery
#661
of 9,162 outputs
Outputs of similar age
#25,621
of 346,030 outputs
Outputs of similar age from Annals of Surgery
#19
of 109 outputs
Altmetric has tracked 25,837,817 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 95th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 9,162 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 13.4. This one has done particularly well, scoring higher than 91% of its peers.
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We're also able to compare this research output to 109 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 82% of its contemporaries.