Availability of acute care surgeons improves outcomes in patients requiring emergent colon surgery.
Am J Surg
; 202(6): 837-42, 2011 Dec.
Article
en En
| MEDLINE
| ID: mdl-22014648
ABSTRACT
BACKGROUND:
The need for emergent colon surgery is a common cause of severe sepsis/septic shock and mortality among surgical patients. We wanted to benchmark our outcomes against those of the National Surgical Quality Improvement Program (NSQIP). We hypothesized that having acute care surgeons to provide comprehensive perioperative care and rapid source control surgery would improve outcome.METHODS:
We queried the 2005 to 2007 NSQIP dataset and our prospective database for patients with severe sepsis/septic shock requiring emergency colon surgery. Demographics, Acute Physiology and Chronic Health Evaluation II score, sepsis source, and hospital mortality data were obtained for all patients.RESULTS:
Both cohorts were similar with regard to age and sex. The overall mortality rate for patients in our dataset was 28.3% compared with 40.1% in the NSQIP dataset (P = .06). The average Acute Physiology and Chronic Health Evaluation II score for our patients was 31 ± 8.2 with a predicted mortality rate of 73% (P < .0001 when compared with actual mortality rate of 28.3%).CONCLUSIONS:
Patients with severe sepsis/septic shock requiring emergent colon surgery have a high mortality rate. Delivery of comprehensive emergency surgical care by acute care surgeons appears to improve survival.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
2_ODS3
/
4_TD
Problema de salud:
2_cobertura_universal
/
4_sepsis
Asunto principal:
Choque Séptico
/
Evaluación de Resultado en la Atención de Salud
/
Colectomía
/
Enfermedades del Colon
/
Benchmarking
/
Cuidados Críticos
/
Accesibilidad a los Servicios de Salud
Tipo de estudio:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
Límite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Am J Surg
Año:
2011
Tipo del documento:
Article
País de afiliación:
Estados Unidos