Increased risk environment for emergency general surgery in the context of regionalization and specialization.

@article{Beecher2015IncreasedRE,
  title={Increased risk environment for emergency general surgery in the context of regionalization and specialization.},
  author={Suzanne M Beecher and D Peter O'Leary and Ray Mclaughlin},
  journal={International journal of surgery},
  year={2015},
  volume={21},
  pages={
          112-4
        }
}
BACKGROUND The pressures on tertiary hospitals with increased volume and complexity related to regionalization and specialization has impacted upon availability of operating theatres with consequent displacement of emergencies to high risk out of hours settings. METHODS A retrospective review of an electronic emergency theatre list prospectively maintained database was performed over a two year period. Data gathered included type of operation performed, Time to Theatre (TTT), operation start… Expand
Surgeon variation in operating times and charges for emergency general surgery.
TLDR
Reducing variations in operating times and charges represents an opportunity to alleviate the financial burden from EGS procedures. Expand
Definition of Emergency General Surgery (EGS) and Its Burden on the Society
The American Association for the Surgery of Trauma defines the emergency general surgery (EGS) patient as “any patient (inpatient or emergency department) requiring an emergency surgical evaluationExpand
DEVELOPING A TOOLBOX for IDENTIFYING WHEN to ENGAGE SENIOR SURGEONS in EMERGENCY GENERAL SURGERY: A MULTICENTER COHORT STUDY.
TLDR
These findings show the practical feasibility of using a risk assessment tool to direct senior surgeons' involvement in emergency general surgery. Expand
The Need to Consider Longer-term Outcomes of Care: Racial/Ethnic Disparities Among Adult and Older Adult Emergency General Surgery Patients at 30, 90, and 180 Days
TLDR
Racial/ethnic disparities exist in longer-term outcomes of EGS patients and are, in part, determined by differences in factors associated with emergency care, as demonstrated by survival analysis of 2007 to 2011 California State Inpatient Database. Expand
Pro-con debate on regionalization of emergency general surgery: controversy or common sense?
TLDR
A unique pro–con debate highlighting the salient arguments for and against regionalization of EGS care in the USA is presented. Expand
Fournier's gangrene: diagnosis and management aided by repeated clinical examination and ultrasound
TLDR
A man aged 57 years admitted to the authors' tertiary centre via his general practitioner, presenting with a 1-week history of scrotal pain, testicular swelling and fluctuance, was suggestive of Fournier's gangrene. Expand
Do Inflammatory Indices Play a Role in Distinguishing between Uncomplicated and Complicated Diverticulitis?
TLDR
The indices cut-off points highlighted in this study should be considered at the time of diagnosis in combination with radiological features of complicated diverticulitis. Expand
Magnitude and modifiers of the weekend effect in hospital admissions: a systematic review and meta-analysis
TLDR
The overall quality of evidence for inferring weekend/weekday difference in hospital care quality from the observed weekend effect was rated as ‘very low’ based on the Grading of Recommendations, Assessment, Development and Evaluations framework. Expand
An Appraisal of Inflammatory Markers in Distinguishing Acute Uncomplicated and Complicated Appendicitis
TLDR
Inflammatory marker cutoff points can be generated and utilized to differentiate between UAP and CAP, and may be useful when deciding between conservative and operative management. Expand
Diagnostic and prognostic significance of complete blood count parameters in retrocecal appendicitis
Yusuf Tanrıkulu1, Suleyman Kargın1, Ceren Sen Tanrıkulu2 1Department of General Surgery, KTO Karatay University, Faculty of Medicine 2Department of Emergency Medicine, Health Sciences University,Expand
...
1
2
...

References

SHOWING 1-10 OF 10 REFERENCES
Emergency surgery pre-operative delays - realities and economic impacts.
TLDR
One third of patients waited longer than 24 h for emergency surgery, with the elderly disproportionately represented in this group, and Vascular and urological emergencies are significantly disadvantaged in competition with other services for a shared emergency theatre. Expand
Delayed versus immediate surgery in acute appendicitis: do we need to operate during the night?
TLDR
Delayed management of acute nonperforated appendicitis allows greater efficiency and effective use of physician and hospital resources, including decreased resident involvement in operations during the night. Expand
The effect of a dedicated emergency theatre facility on emergency operating patterns.
TLDR
Following the introduction of a dedicated 24-hour emergency theatre facility in a 500-bed district general hospital, the total amount of emergency general surgery performed after 22.00 hours has been reduced, and senior supervision has been enhanced. Expand
An audit of the effect of a 24-hour emergency operating theatre in a district general hospital.
The recent introduction of a 24-hour emergency theatre for General Surgery provided an opportunity to audit its effect on emergency operating in a District General Hospital. Prior to its introductionExpand
Emergency surgery: half a day does make a difference.
The emergency operating patterns in a district general hospital were significantly altered by the introduction of an afternoon emergency theatre list co-ordinated by a consultant anaesthetist. BeforeExpand
Emergency Surgery: Atavistic Refuge of the General Surgeon?
A prospective audit of emergency soft-tissue surgery for an eight-week period revealed that general surgical emergency operations were more than twice as common as those undertaken in otherExpand
Weekend mortality for emergency admissions. A large, multicentre study
TLDR
This is the largest study published on weekend mortality and highlights an area of concern in relation to the delivery of acute services. Expand
Effect of regional trauma centralization on volume, injury severity and outcomes of injured patients admitted to trauma centres
TLDR
Evaluating how a regional trauma network affected trends in admissions, case mix, and outcomes of injured patients found it difficult to assess the centralization of major trauma services. Expand
Overnight and postcall errors in medication orders.
  • G. Hendey, B. Barth, T. Soliz
  • Medicine
  • Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
  • 2005
TLDR
Medication-ordering error rates were higher for overnight and postcall physicians, particularly on the general medical/surgical wards, and in PGY1 physicians during the overnight period. Expand
Who Operates When? II: The National Confidential Enquiry into Perioperative Deaths 2003.
The National Confidential Enquiry into Perioperative Deaths (NCEPOD) recently published its report entitled Who Operates When? II (WOW II) (NCEPOD, 2003). This report examined changes in surgical andExpand