Role of interprofessional teams in emergency general surgery patient outcomes.
Surgery
; 168(2): 347-353, 2020 08.
Article
em En
| MEDLINE
| ID: mdl-32527647
ABSTRACT
BACKGROUND:
In response to duty hour restrictions, hospitals expanded residency programs and added advanced practice providers. We sought to determine if type of clinical support was associated with emergency general surgery outcomes.METHODS:
As part of our 2015 survey of acute care hospitals, we asked hospitals whether residents and advanced practice providers participate in emergency general surgery care. Data from responding hospitals were linked to patient data (≥18 years old admitted with an emergency general surgery diagnosis) from 17 State Inpatient Databases using American Hospital Association identifiers. Analyses compared emergency general surgery patient and hospital characteristics based on type of providers assisting emergency general surgery surgeons (none, only advanced practice providers, only residents, or both). Multivariable analysis determined if presence of advanced practice providers and/or residents was associated with type of management, mortality, or complications.RESULTS:
Eighty-three hospitals and 49,271 unique emergency general surgery admissions were included. Hospitals without residents and advanced practice providers were most likely to manage patients operatively. However, hospitals with residents (alone or with advanced practice providers) had reduced odds of systemic complication compared with hospitals without clinical support (adjusted odds ratio 0.77 [95% confidence interval 0.60-0.98] and adjusted odds ratio 0.77 [95% confidence interval 0.62-0.95], respectively), while hospitals with only residents had the lowest odds of operative complication.CONCLUSION:
Our findings highlight the positive effect residents (alone or partnering with advanced practice providers) can have on emergency general surgery patient outcomes.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Equipe de Assistência ao Paciente
/
Procedimentos Cirúrgicos Operatórios
/
Emergências
Tipo de estudo:
Prognostic_studies
Limite:
Adolescent
/
Adult
/
Female
/
Humans
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Male
/
Middle aged
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article