The Successful Implementation of a Trauma and Acute Care Surgery Model in Ecuador
| Autor: | Edgar B. Rodas, Juan Carlos Puyana, Nube Flores Lazo, Hernán Sacoto Aguilar, Amber Himmler, Doris Sarmiento Altamirano, Óscar Chango Sigüenza, Jeovanni Reinoso Naranjo, Lenin Fernández de Córdova, Juan Carlos Salamea Molina, Raúl Pino Andrade |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Critical Care MEDLINE Cohort Studies 03 medical and health sciences 0302 clinical medicine Medicine Humans Acute care surgery Hospital Mortality business.industry Emergency department Vascular surgery Length of Stay Cardiac surgery Cardiothoracic surgery 030220 oncology & carcinogenesis Emergency medicine Wounds and Injuries 030211 gastroenterology & hepatology Surgery Ecuador business Emergency Service Hospital Abdominal surgery Cohort study |
| Zdroj: | World journal of surgery. 44(6) |
| ISSN: | 1432-2323 |
| Popis: | For years, surgical emergencies in Ecuador were managed on a case-by-case basis without significant standardization. To address these issues, the Regional Hospital Vicente Corral Moscoso adapted and implemented a model of “trauma and acute care surgery” (TACS) to the reality of Cuenca, Ecuador. A cohort study was carried out, comparing patients exposed to the traditional model and patients exposed to the TACS model. Variables assessed included number of surgical patients attended to in the emergency department, number of surgical interventions, number of surgeries performed per surgeon, surgical wait time, length of stay and in-hospital mortality. The total number of surgical interventions increased (3919.6–5745.8, p ≤ 0.05); by extension, the total number of surgeries performed per surgeon also increased (5.37–223.68, p ≤ 0.05). We observed a statistically significant decrease in surgical wait time (10.6–3.2 h for emergency general surgery, 6.3–1.6 h for trauma, p ≤ 0.05). Length of stay decreased in trauma patients (9–6 days, p ≤ 0.05). Higher mortality was found in the traditional model (p ≤ 0.05) compared to the TACS model. The implementation of TACS model in a resource-restrained hospital in Latin America had a positive impact by decreasing surgical waiting time in trauma and emergency surgery patients and length of stay in trauma patients. We also noted a statistically significant decrease in mortality. Savings to the overall system and patients can be inferred by decreased mortality, length of stay and surgical wait times. To our knowledge, this is the first implementation of a TACS model described in Latin America. |
| Databáze: | OpenAIRE |
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