Details

Autor(en) / Beteiligte

• Feeney, Timothy
• Castillo-Angeles, Manuel
• Scott, John W.
• Nitzschke, Stephanie L.
• Salim, Ali
• Haider, Adil H.
• Havens, Joaquim M.

Titel

The independent effect of emergency general surgery on outcomes varies depending on case type: A NSQIP outcomes study

Ist Teil von

• The American journal of surgery, 2018-11, Vol.216 (5), p.856-862

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2018

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• Emergency general surgery (EGS) is an independent risk factor for morbidity and mortality, and seven procedures account for 80% of the National burden of operative EGS. We aimed to characterize the excess morbidity and mortality attributable to these procedures based on the level of procedural risk. Retrospective analysis of the ACS National Surgical Quality Improvement Project (ACS-NSQIP) database. (2005–2014). Seven EGS procedures were stratified as high risk and low risk. Primary outcomes were overall mortality, overall morbidity, major morbidity. Multivariable logistic regression was performed. There were 619,174 patients identified. Comparing EGS to non-EGS in high-risk cases the OR for overall mortality was 1.39(1.33,1.45), overall morbidity 1.07 (0.98, 1.16), and major morbidity 1.15(1.03,1,27). In low-risk cases the OR for overall mortality was 1.03 (0.89, 1.19) overall morbidity 1.35 (1.23, 1.48), and major morbidity 2.18(1.90, 2.50). Using a Nationally representative clinical database we identified significant heterogeneity in the outcomes of EGS depending on procedural risk. Risk stratification and benchmarking strategies need to account for the inherent heterogeneity of EGS. •Emergency General Surgery cases are comprised of a heterogeneous group of procedures.•The effect of emergent case designation on outcomes varies with case type.•Cases with low baseline risk have an increased odds of morbidity only.•Cases with high baseline risk have an increased odds of major morbidity and all-cause mortality.