The Impact of Acute Care Surgery Model on the Management of Acute Appendicitis and Cholecystitis: A Single-Center Study.

Autor:	Al Babtain I; Department of General Surgery, King Abdulaziz Medical City Riyadh, Riyadh, SAU., Alraee SA; Department of General Surgery, King Abdulaziz Medical City Riyadh, Riyadh, SAU.; Medicine and Surgery, King Saud bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU., Shalhoub MM; General Surgery, King Saud University, Riyadh, SAU., Hijazi LO; Medicine and Surgery, King Saud bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU., Albalawi AA; Medicine and Surgery, King Saud bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU., Alamer M; Medicine and Surgery, King Saud bin Abdulaziz University for Health Sciences College of Medicine, Riyadh, SAU.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2022 Jul 10; Vol. 14 (7), pp. e26724. Date of Electronic Publication: 2022 Jul 10 (Print Publication: 2022).
DOI:	10.7759/cureus.26724
Abstrakt:	Background Acute care surgery (ACS) is a novel model for the provision of emergency general surgery (GS) care. Investigating the impact of the ACS team on the management of acute emergencies can help in establishing proper management measures and improving patient care in an emergency setting. The study aims to compare the performance indicators and patient outcomes such as hospital length of stay (LOS), time to diagnosis, and operation before and after the implementation of the acute care system. Methods The study reviewed two retrospective cohorts: the pre-ACS system (n = 202) from January 2012 to December 2013 and the post-ACS system (n = 188) from January 2014 to December 2015, which were done in a tertiary care center. All adult patients diagnosed with acute appendicitis and cholecystitis requiring emergency surgery were included. Results There was an improvement in the time interval between GS referral to the diagnosis of acute appendicitis and cholecystitis (p = 0.07) and from diagnosis to the start of the operation (p = 0.38). Patients in the post-ACS model had a shorter hospital stay than the pre-ACS model patients with [M = 3.69 SD(3.18) days versus M = 3.57 SD (3.60) days, p = 0.25]. Time from the emergency department arrival to GS referral did not show an improvement [M = 4.36 SD(3.34)] hours in the pre-ACS model versus [M = 4.53 SD(3.98)] hours in the ACS model, p = 0.86). Conclusion The ACS model led to earlier diagnosis of acute appendectomy and cholecystectomy cases and reduced the LOS. The introduction of the ACS model in Saudi Arabia showed improvement in patient care during acute emergencies. Further studies including multiple centers with larger sample sizes and longer review periods are needed to evaluate the efficiency and cost-effectiveness of the ACS model. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2022, Al Babtain et al.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu