Evidence map›Paper›PMID 41528489›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2026

Propensity score matching analysis of acute care (ACS) versus colorectal surgeons (CRS) in the management of left colonic perforation: Patient and system-level insights from a multicenter study.

Stefano Piero Bernardo Cioffi, Stefania Cimbanassi, Mauro Podda, Antonio La Greca, Alan Biloslavo, Federico Coccolini, Marco Ceresoli

Abstract readMulticenter StudyComparative Study
PubMed Publisher
In one paragraph

Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2026. 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. Observational
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

7 authors.

Stefano Piero Bernardo CioffiEmergency Surgery and Major Trauma Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy. stefanopiero.cioffi@ospedaleniguarda.it.ORCID http://orcid.org/0000-0002-5453-8901
Stefania CimbanassiEmergency Surgery and Major Trauma Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
Mauro PoddaDepartment of Surgical Science, University of Cagliari, Cagliari, Italy.
Antonio La GrecaEmergency Surgery and Trauma Unit, Fondazione IRCCS Policlinico Universitario A Gemelli Roma, Rome, Italy.
Alan BiloslavoDepartment of General Surgery, Cattinara University Hospital, Trieste, Italy.
Federico CoccoliniGeneral, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy.
Marco CeresoliSchool of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLeft-sided colonic perforation is a severe surgical emergency requiring prompt, technically expert intervention. In Italy, the coexistence of heterogeneous Acute Care Surgery (ACS) models and traditional Colorectal Surgery (CRS) programs provides a unique context to assess differences in outcomes and management for this condition.

methodsWe conducted a retrospective, multicenter cohort study across six tertiary Italian hospitals (2019–2023) including patients undergoing emergency resection for left-sided colonic perforation. Patients treated by ACS or CRS teams were compared after 1:1 propensity score matching for demographic, clinical, and operative factors. The primary outcome was in-hospital mortality. Secondary outcomes included surgical strategy, minimally invasive use, postoperative complications, reoperation, readmission, 12-month survival, and stoma reversal.

resultsOf 516 eligible patients, 437 were analyzed (287 ACS, 150 CRS). After matching, 117 patients per group were balanced for 10/11 covariates. In-hospital mortality did not differ (ACS 9.4% vs. CRS 15.4%; p = 0.234), nor did 12-month survival (ACS 80.0% vs. CRS 77.5%; p = 0.813). ACS teams used more conservative strategies (Hartmann’s 47.9% vs. CRS 35.0%), with lower rates of successful laparoscopy (8.6% vs. 18.8%; p = 0.036). Notably, ACS management was associated with significantly fewer unplanned reoperations (8.6% vs. 28.2%; p < 0.001) and hospital readmissions (5.7% vs. 17.4%; p = 0.017). Severe complication rates and anastomotic leak incidence were not significantly different, despite favorable trends for ACS.

conclusionsIn a nationwide matched cohort, ACS surgeons achieved outcomes equivalent to CRS specialists for left-sided colonic perforation, with lower reoperation and readmission rates despite lower rates of primary anastomosis and less frequent successful minimally invasive procedures. ACS may have prioritized physiology oriented approaches rather than anatomical ones, resulting in possible better patients’ selection. These findings support ACS as a safe and effective model of emergency surgical care in Italy, underscoring the need for structured training programs and investment in minimally invasive skills to enhance system performance and policy planning.

Indexed as

Colonic DiseasesIntestinal PerforationAcute Care SurgeryAgedColorectal Surgical ProceduresFemaleHospital MortalityHumansItalyMaleMiddle AgedPostoperative ComplicationsPropensity ScoreReoperationRetrospective StudiesAcute care surgeryColorectal surgeryEmergency general surgeryPropensity score matching

Identifiers

PMID41528489

What Socratic holds

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Registered trials

None linked

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 Socratic graph.