Faculty Collaboration Database

Beyond just the operating room: characterizing the complete caseload of a tertiary acute care surgery service. Can J Surg 2018 Aug;61(4):264-269

Date

08/02/2018

Pubmed ID

30067185

Pubmed Central ID

PMC6066387

DOI

10.1503/cjs.007417

Scopus ID

2-s2.0-85054871440 (requires institutional sign-in at Scopus site)   8 Citations

Abstract

BACKGROUND: Most studies evaluating acute care surgery (ACS) models of care for patients with emergency general surgery (EGS) conditions have focused on patients who undergo surgery while admitted under the care of the ACS service. The purpose of this study was to prospectively examine the case mix of admissions and consultations to an ACS service at a tertiary centre to identify the frequency and distribution of both operatively and nonoperatively managed EGS conditions.

METHODS: In this prospective cohort study, we evaluated consecutive patients assessed by the ACS team between July 1 and Aug. 31, 2015, at a large Canadian tertiary care centre. This included all consultations and outside hospital transfers. Diagnoses, demographic characteristics, comorbidities, intervention(s), complications, readmission and in-hospital death were captured.

RESULTS: The ACS team was involved in the care of 359 patients, 176 (49.0%) of whom were admitted under the direct care of the ACS team. Nonoperative care was indicated in 82 patients (46.6%) admitted to the ACS service and 151 (82.5%) of those admitted to a non-ACS service (p < 0.001). Bowel obstruction (37 patients [21.0%]) was the most common reason for admission, followed by wound/abscess (24 [13.6%), biliary disease (24 [13.6%]) and appendiceal disease (23 [13.1%]). Rates of 30-day return to the emergency department and readmission were 17.0% and 9.1%, respectively, and the in-hospital mortality rate was 1.7%.

CONCLUSION: Acute care surgery teams care for a wide breadth of disease, a considerable amount of which is managed nonoperatively.

Author List

van Zyl TJ, Murphy PB, Allen L, Parry NG, Leslie K, Vogt KN

Author

Patrick Murphy MD Assistant Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Canada
Critical Care
Female
Hospital Mortality
Humans
Length of Stay
Male
Middle Aged
Prospective Studies
Surgery Department, Hospital
Tertiary Healthcare
Workload