Impact of an acute surgical unit on outcomes in acute cholecystitis.
ANZ J Surg
; 88(12): E835-E839, 2018 12.
Article
em En
| MEDLINE
| ID: mdl-30207047
ABSTRACT
BACKGROUND:
The acute surgical unit (ASU) model has been associated with improved outcomes for emergency general surgical patients. Few Australasian studies have investigated patients with cholecystitis and none from South Australia.METHODS:
A retrospective cohort study compared patients admitted to our institution with acute cholecystitis during the 2 years before (traditional period) and after (ASU period) introduction of an ASU on 1 August 2012. Primary outcomes were length of stay, rates of definitive surgery on index admission, time to definitive surgery and proportion of cases performed in-hours. Secondary outcomes were time from emergency department referral to admission, time from radiologically confirmed diagnosis to theatre start, rates of conversion to open cholecystectomy, complications and cholelithiasis-related representations while awaiting definitive procedure.RESULTS:
A total of 319 patients met the inclusion criteria; 172 and 147 pre- and post-ASU introduction, respectively. Compared with the traditional period, ASU patients had shorter length of stay (3.80 versus 2.83 days, P < 0.0001), higher rates of surgery on index admission (70.9% versus 95.3%, P < 0.0001), shorter time to definitive surgery (28.1 versus 22.1 days, P < 0.001), lower rates of conversion to open cholecystectomy (18.0% versus 7.1%, P = 0.007) and fewer complications (24.4% versus 6.1%, P < 0.0001). Other outcomes were not significantly different.CONCLUSION:
Introduction of an ASU was associated with superior outcomes amongst patients admitted with acute cholecystitis. These findings extend the literature in support of the current model of care.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Centro Cirúrgico Hospitalar
/
Colecistectomia
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Colecistite Aguda
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article