bluuebunny/crossref_metadata_2025_split huggingface dataset:
SP7.9 Correlation between Altmetric score and number of citations in 12 high impact factor medicine, surgery and anaesthesia journals
Authors: Adiamah Alfred , Kandiah Kaveetha , Wong Tiffany , Dada Omolade , Igboin Jasmine , Lobo Dileep 
Published: August 2023

Abstract

Introduction
The citation count is traditionally used to measure the impact of scientific publications. The Altmetric attention score (AAS) by contrast, measures the digital dissemination of articles across social media platforms to determine their audience reach. However, whether the AAS correlates with citation counts is currently not well defined. This study, aimed to discern the correlation between citation counts and AAS in medical journals.

Method
We identified 12 highest impact journals in Internal Medicine, Surgery and Anaesthesia and included original articles, systematic reviews, meta-analyses, editorials and research letters published between 1 January 2019 and 31 December 2019. Up-to-date citations and AAS for each article were obtained between 1 and 7 January 2023 using a linked research information dataset, Dimensions Citation Data (https://app.dimensions.ai/discover/publication).

Results
We identified 2790 published manuscripts with median (IQR) AAS and citation scores of 39 (10-152) and 19 (7-56) respectively. Both scores differed by journal specialty, with the highest scores identified in Medicine and lowest in Anaesthesia journals. Randomized clincial trials had both the highest citations and AAS, with research letters having the lowest. There was a positive correlation between AAS and citations (ρ=0.4538; P&lt;0.001). Other factors found to correlate with the citation scores were journal specialty (ρ=0.2047, P&lt;0.001), journal impact factor(ρ=0.4538, P&lt;0.001) and the type of study (ρ=0.4566, P&lt;0.001).

Conclusion
This cross-sectional study, across 12 high impact factor specialty journals found that the AAS correlated with the citation count, suggesting that audience engagement via social media may influence the overall clinical and academic impact of publications.
SP7.11 Outcomes of Elective and Emergency Surgical Repair of Incisional Hernia - A Comparative Observational Study
Authors: Omar Islam , Townsend Abby , Hadfield Oliver , Khogali Moataz , Wilson Jeremy , Magee Conor 
Published: August 2023

Abstract

Aims
Incisional hernia (IH) is a common complication after abdominal surgery. This study aims to describe and compare the outcomes of IH's elective and emergency surgical repair.

Methods
A single-centre comparative retrospective study including all patients who had surgical repair of IH. The patients were divided into Group I (Emergency) and Group II (Elective). A comparison was made between the two groups.

Results
262 patients were identified with a mean age of 61.8 SD±14.2 years, and 152 (58%) were females. More than 58% had at least one comorbidity. 169 (64.5%) had elective, and 93 (35.5%) had emergency repair. Patients undergoing emergency repair of IH were significantly older and had higher BM, p= 0.031 and 0.002, respectively.
The overall complication rate in the full cohort was 46.2%, and the significant complication rate (Clavien-Dindo III and IV) was 9.54%. The 30-day and 90-day mortality rates were 6 (2.3%) and 7 (2.68%), respectively.
In the emergency group, the complications, 30-day and 90-day mortality rates were significantly higher than in the elective group, p= &lt;0.001, 0.002 and 0.001, respectively. The emergency group had a significantly longer hospital stay, and more of them needed a higher level of care, p= &lt;0.001 each.
Overall, 42 (16.1%) developed wound complications, 25 (9.6%) patients had a recurrence, and 41 (15.71%) had 90-day readmissions without significant differences between the two groups.

Conclusions
IH is associated with medical comorbidity and high BMI. Emergency repair of IH is associated with higher complication rates and mortality compared to elective repair.
SP7.12 One stop multi-speciality Chronic Postoperative Inguinal Pain Clinic – implementation outcomes
Authors: Cocciolo Federica , Birch Alice , Al-Abbasi Iea , Pawlak Maciej 
Published: August 2023

Abstract

Aim/Objective
The aim on this presentation is to assess patients’ feedback as well as the outcomes of individualised treatment plans for patients assessed in the multidisciplinary team (MDT) clinic. The primary endpoint was quality of life and pain improvement 3 months after receiving treatment.

Material and methods
All patients reviewed in MDT CPIP clinic in the Comprehensive Hernia Centre between July 2021 and July 2022 were included in the study. Patients feedback as well as MDT individualised treatment plans were assessed. The outcomes, Visual Analogue Scale (VAS) and modified Activity Assessment Scale (mAAS) 3 months post intervention have been audited against data collected prior to intervention.

Results
We have received 57 referrals during the investigated period. 40 patients underwent MDT assessment with 55% receiving treatment and entering follow-up stage. In that group 26% had surgery, 35% had invasive non-surgical treatment (local injections and radiofrequency ablation), 39% were qualified for pharmacological treatment, together with physiotherapy and psychological support. Follow up data was collected for 19/22 patients. All patients had reported moderate to significant pain (VAS 4-10) on initial assessment and a significant reduction in pain (&gt; 50% improvement in VAS) after treatment. Mean baseline mAAS score was 20.3± 7.3 (range 8 to 40). Mean change was - 10.6±2.6 with all patients reporting significant improvement (&gt; 50%). Moreover, on a scale from 0 to 5, the average satisfaction score was 4.5.

Conclusion
Developing a multidisciplinary clinic to assess patients presenting with CPIP improved patients’ experiences and outcomes. Enhancing patient-centred care.
SP8.2 Management of Acute Surgical Abscesses (MAGIC): National prospective audit
Authors:   White Rose Surgical Research Collaborative (WRSC)
Published: August 2023

Abstract

Aim
Subcutaneous abscesses are common, accounting for 2% of all emergency attendances. The aim of this project was to describe the management and outcomes associated with the management of subcutaneous abscesses in surgical practice.

Method
A national, prospective audit was undertaken. Adult patients presenting to an acute general surgical service with a subcutaneous (non-perianal) abscess between September and December 2022 were included. Data relating to their presentation, management, and outcomes were collected. Outcomes of interest included rates of recurrence, readmission, and complications within 60 days of treatment. A centre-level survey was administered to gather data on clinical resource use and sustainable practices.

Results
A total of 1247 patients were included across 55 centres. The most common abscess locations were pilonidal (18.8%), posterior thorax (14.5%), and buttock (11.7%). The majority (84.4%) were treated with incision and drainage and half (51.9%) of these also received antibiotics. Surgery was mostly performed with general (65.2%) or local (33.0%) anaesthesia. The rates of recurrence (5.7% vs. 6.7%) and readmission (14.0 vs. 10.3%) were broadly similar, respectively. A quarter (26.6%) of hospitals incorporated dedicated abscess management pathways. The majority of hospitals used single-use items for abscesses drained in ambulatory/ward areas (90.2%) but not in the operating room (13.7%).

Conclusions
Wide variation exists in the management of subcutaneous abscesses. These data, along with other preparatory work, may justify a trial of general and local anaesthesia in appropriately selected patients.
SP8.4 National variation in the management of pancreatitis and the effect on patient outcome
Authors: Javanmard-Emamghissi Hannah , Knight Stephen , Kosti Angeliki , Hollyman Marianne ,   PANC Study
Published: August 2023

Abstract

Aim
Pancreatitis is one of the most common general surgical presentations, but there is variation in how patients are managed. Our aim was to assess the degree of variation across the United Kingdom (UK) and how it affects patient outcomes.

Method
A multicentre, observational cohort study was carried out across the UK between March-April 2021. Admission variables including whether the unit was a district general or specialist unit were recorded. Imaging and operative details were collected with 30-day outcomes.

Results
Data from 113 hospitals were recorded, including 2580 patients. 24(21%) of these hospitals were specialist units. Imaging rates varied between sites, with ultrasound performed within 24 hours of admission on between 14 and 100% of patients and CT between 22 and 100% of patients. Between 0% and 100% of patients received a laparoscopic cholecystectomy within 30 days. Median length of stay was 5 days, but increased to 6 days in low volume centres (p=0.01).
Variation in access to ultrasound and to surgery were related to hospital volume, but not whether they were a tertiary unit. Mortality and readmission rates were not correlated to hospital volume but unplanned readmission was higher in non-specialist centres (18.1%v14.4%, p=0.024).

Conclusions
There is significant inequity in accessing best practise pancreatitis care in the UK, based on admitting hospital. Case volume at a hospital was more significantly associated with access to imaging and surgery, than being a specialist centre, however specialist centres achieved lower rates of unplanned readmission.
SP8.5 Emergency laparoscopic and open right hemicolectomy for right colonic malignancy: A retrospective comparative single centre study
Authors: Hussain Mohammad Iqbal , Sakib Najmu , Stefan Samuel , Khan Jim 
Published: August 2023

Abstract

Aim
Minimally invasive surgery has gained wide acceptance in general surgery and is being increasingly used to treat colon cancers. However, there are no randomized controlled trials comparing laparoscopic against open emergency colectomies. This study aims to compare the clinical and pathological outcomes for laparoscopic and open right colectomy in the emergency setting.

Methods
This single-centre study involved a total of 201 patients who underwent emergency laparoscopic and/or open right hemicolectomy for right colonic malignancy between 2009 and 2019.

Results
A total of 201 right colectomies were performed. Among these procedures, 84 were operated laparoscopically and 117 with an open midline laparotomy. In the laparoscopic group, 13 were converted to open procedures. Patient demographics were similar across both groups with regard to age, sex, BMI, ASA grade, and tumour stage. Patients in the laparoscopic group had significantly shorter hospital stays [Median = 8 vs. 13 days], higher number of lymph nodes harvested [Median = 22 vs 18]. Postoperative ileus was less common in the open group than in the laparoscopic group [9(7.7%) vs 7(8.3%), P= 1.000]. There was no significant difference in major complications, anastomotic leak, and mortality. Median 5-year DFS for the laparoscopic group was 9.9 months in comparison to 9.7 months. Median OS for the laparoscopic group was 15.6 months compared to 12.3 months in the open group.

Conclusions
Emergency laparoscopic right hemicolectomy seems to be safe with equivalent oncological outcomes to open surgery. Randomized control trials are required to further investigate the role of laparoscopy in emergency surgery for right colon cancers.
SP8.6 Postoperative recovery - is there a psychological impact? Evaluation of psychological impact following emergency surgery
Authors: Kho Jason , Fitzpatrick Stephanie , Ward Jeremy , Date Ravindra , Rajendran Ilayaraja 
Published: August 2023

Abstract

Aim
Undergoing ‘Emergency operation’ (EO) is a stressful event for patients however, the impact on mental health has not been studied. Study aims to evaluate the psychological impact during early postoperative period following EO using the standardised Patient Health Questionnaire-4 (PHQ-4).

Methods
Prospective study from hospital database. Age&gt;18years who underwent emergency general surgical procedures between November-December 2022 were included. Procedures were classed as major(laparotomy) or moderate/minor. Patients were contacted two to four weeks postoperative to answer four questions within PHQ-4, assessing mood, anhedonia, anxiety and nervousness. Frequency of experiencing those negative emotions was graded from 0 (not at all) to 3 (nearly everyday). Data was analysed to identify potential factors associated with higher PHQ-4 scores. P-value&lt;0.05 was statistically significant.

Results
19 patients participated in the survey; 10(52.6%) male and 8(42.1%) female. Median age was 45±40years. Overall, nearly one-third of patients experienced some psychological impact during early postoperative period. 4(5.3%) patients reported feeling nervous, 6(31.6%) reported anxiety, 7(36.8%) reported anhedonia and 5(26.3%) reported feeling low. 2(10.5%) patients reported feeling these emotions nearly everyday. 6(31.6%) patients underwent major surgery. Higher PHQ-4 scores were found in the major group(n=6/19(31.6%), 5±8) vs non-major(n=13/19(68.4%), 3±1; p=0.051). There was a positive correlation between postoperative length of stay and PHQ-4 score (Spearman coefficient R=0.67, p=0.0016).

Conclusion
Psychological impact was more pronounced in patients undergoing major surgery, particularly those with protracted recovery. Although limited by sample size, study reveals the need for formal psychological support for patients undergoing EO.
SP8.8 Necrotising fasciitis: A retrospective single-centre 10-year experience
Authors: Prentice Erin , Geropoulos Georgios , Damaskos Dimitrios 
Published: August 2023

Abstract

Aims
Necrotizing fasciitis (NF) is a life-threatening condition with early diagnosis and goal-directed resuscitation critical to improve perioperative outcomes. The aim of this study is to review our experience and define trends in the incidence, presentation, morbidity, mortality and management of NF cases.

Method
Case notes from 1st October 2012 to 30 September 2022 were retrieved. Data was collected in regard to the patient demographic, risk factors, initial presentation, laboratory findings, surgical approach, length of stay in the intensive care unit (ICU), additional operation requirements and 30-day mortality.

Results
Medical records of 59 patients were reviewed. 58% of patients were male and patient age ranged from 24 to 84 years old with average age of presentation 53.
91% of cases had one or more risk factors identified with 36% of patients being diabetic, and 54% of patients obese. At initial presentation 51% were tachycardic, 46% had a fever and 32% were hypotensive with average CRP 313 and WCC 20. Computerized tomography (CT) was completed prior to surgical debridement in 39% of cases of which 74% of CT scans showed subcutaneous gas. 91% of cases were polymicrobial. 80% of patients required ICU support postoperatively with average length of stay of 9.8 days. 24% required defunctioning stomas and in 39% of cases, VAC dressings were applied. 30-day mortality was 10%.

Conclusion
Necrotising fasciitis carries a significant morbidity and mortality risk. Systemic upset is not always present at initial presentation and clinical suspicion should be increased with high CRP and WCC in the presence of known risk factors.
SP8.11 The EXTEND trial: EXTENDed antibiotics to improve outcomes in patients with complicated Intra-Abdominal Infection (cIAI)
Authors: O'Connor Olivia , Ahmed Shadia , Kirby Andrew , Burke Dermot , Pinkney Thomas , Szakmany Tamas 
Published: August 2023

Abstract

Introduction
Complicated intra-abdominal infections (cIAI) pose a major challenge in surgical patients. Despite the heterogenous aetiology they have a common disease process, which is bacterial infection of the peritoneal space. Hence, all cIAIs are managed with source control, plus antibiotic therapy. However, there is uncertainty regarding the optimal antibiotic treatment strategy in order to prevent relapse or extra-abdominal spread of infection1. At present, there is no UK guidance on the management of cIAIs2. For other serious infections outside the abdomen microbiologists often advise at least 28-days of antibiotic therapy. Currently the effectiveness of extended duration antibiotics in patients with cIAI is unknown. This trial aims to compare the clinical and cost effectiveness of 28-day duration antibiotics with standard care with respect to rate of treatment failure in patients with cIAIs. Secondary outcomes include complications and quality of life.

Method
A multicentre, open label, two-arm, parallel group, pragmatic, randomised controlled trial with internal pilot. A total of 1166 consenting adult patients with cIAI will be recruited over 3 years and randomised on a 1:1 basis between 28-days antibiotics and standard care antibiotics. Patients will be recruited from ICUs and hospital in-patient wards across 30 sites. Recruitment commenced September 2022.

Trial management and funding
EXTEND is sponsored by University of Leeds and hosted by York Trials Unit. It is funded by the NIHR. The Trial Management Group will oversee design and running of the trial. Each site will have a Principal Investigator (PI) with local responsibility. The NIHR Associate PI scheme will be adopted to enable trainees to participate in the trial.
SP9.1 Increasing use of non-operative management in high grade splenic trauma
Authors: Clymo Jonathon , Platt Esther , Tekle Kifle , Kashef Elika , Batting Sarah , Frith Dan 
Published: August 2023

Abstract

Aims
The aim was to review the success of non-operative management (NOM) in the management of splenic trauma at our Major Trauma Centre (MTC).

Methods
We performed a retrospective data collection of all adults presenting to a London MTC with radiological evidence of splenic injury between 2014 and 2021. Electronic patient records were reviewed. Splenic injury was graded by a consultant radiologist. Patients too unstable to undergo a pre-operative CT for radiological injury grading were excluded from the analysis.

Results
Data was available for 337 patients, of which 28 patients went straight to theatre without imaging. 234 (75.7%) patients had AAST grade I-III splenic injury, 52 (16.8%) had grade IV and 23 (7.4%) had grade V injury. Successful NOM was achieved in 88.5% of patients with grade I-III splenic injury, 78.8% grade IV and 26.1% grade V injury. Patients with grade IV injury were more likely to undergo NOM without embolisation compared to grade V injury (OR=13.14, p=0.00058). The proportion of NOM grade IV injury increased significantly from 2017 to 2021 (OR= 16.94, p=0.001). There was also a significant difference between the rate of successful embolisation between grade IV and V splenic injury (OR=9.27, p=0.0003). Of patients undergoing operative management, grade I-III patients had a significantly higher chance of spleen salvage compared to grade IV-V patients (OR=34.5, p&lt;0.00001).

Conclusions
This data demonstrates our increasing confidence in NOM for successful management of high-grade (IV-V) splenic trauma. Further research is required to identify specific patient characteristics associated with successful use of NOM.
SP9.3 A 5-year retrospective review of “Code Red” traumas requiring immediate surgery in a regional major trauma centre
Authors: Winter Jonathan , Canny John , Harbinson Daniel , Yoong Susan 
Published: August 2023

Abstract

Aim
Trauma is a major cause of mortality leading to over 16,000 deaths annually in England and Wales alone. Code red traumas are the most extreme of these and a proportion will require immediate operative intervention. The aim of this study was to review the outcomes of patients presenting to a regional major trauma centre as code red traumas requiring immediate transfer to theatre and to identify a pathway to facilitate this process.

Methods
Data were reviewed for all Code Red Traumas requiring immediate operative intervention between April 2017 and April 2021. Electronic records were searched to identify aetiologies, transfer times and post-operative morbidities and mortalities. Datasets were collected and analysed using Microsoft Excel software.

Results
57 patients were identified and included. The average age was 39 years old. CT was performed in 52/59 patients (88.1%) and median time to CT was 32 minutes. All patients proceeded to theatre with an overall median time to theatre of 144.5 minutes. In hospital mortality was 19.3% (n=11). Primary operating speciality varied with general surgery making up the majority with 30 cases. A consultant surgeon was present in 72% of cases and a consultant anaesthetist in 81% of cases. 84% (n=48) of patients were admitted to ICU post-operatively.

Conclusions
Major trauma remains a significant cause of mortality in our cohort. We have developed a pathway for those requiring direct access to theatre. It is envisaged that this will facilitate expediated transfer to theatre and lead to improved patient outcomes.
SP9.4 Improving time to initial consultant review for emergency general surgery admissions at a major trauma centre
Authors: Ingram-Walpole Shannon , Bailey Rob , Macutkiewicz Christian 
Published: August 2023

Abstract

NHS England’s Seven Day Services Clinical Standards and NCEPOD Guidance recommend 100% of emergency admissions to hospital should receive an initial consultant review within 14-hours of hospital admission. An audit of time for initial consultant review for emergency general surgery (EGS) admissions at a Major Trauma Centre revealed only 75% of patients were reviewed by a consultant surgeon within the 14-hour target, with longest time to review 20 hours and 56 minutes.

Aim
To assess and improve compliance of time to initial consultant review for EGS admissions with the recommended standard by implementing twice daily versus once daily post take ward rounds (PTWR).

Standard
100% of EGS admissions should have a consultant review within 14-hours of hospital admission.

Methods
Retrospective review of admission data and progress notes on the electronic medical record for all patients admitted under EGS from 00:00 Monday 26/9/2022 – 23:59 Friday 30/9/22 (identified from general surgery take list) three weeks post intervention. Data inputted onto a single audit tool and analyzed in Microsoft Excel in comparison to initial audit data (one month prior to intervention).

Results
Twice daily compared to once daily PTWRs improved compliance with the audit standard by 25%; 100% of patients reviewed within 14-hours. Longest time for initial consultant review decreased by 11hr 04min (20hr 56min to 09hr 52min). Number of patients reviewed in the emergency department by a consultant increased from 25% to 50%.

Conclusions
100% of EGS patients can receive an initial consultant review in line with the nationally recommended timeframe with the introduction of twice daily versus once daily PTWRs.