Details

Autor(en) / Beteiligte

• Matevish, Lauren E.
• Medvecz, Andrew J.
• Ebersole, Joseph M.
• Wanderer, Jonathan P.
• Eastham, Shannon C.
• Dennis, Bradley M.
• Guillamondegui, Oscar D.

Titel

The Silent Majority of Emergency General Surgery: An Assessment of Consult and Operative Volumes

Ist Teil von

• The Journal of surgical research, 2021-03, Vol.259, p.217-223

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2021

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Defining the work performed by emergency general surgery (EGS) surgeons has relied on quantifying surgical interventions, failing to include nonsurgical management performed. The purpose of this study was to identify the extent of operative and nonoperative patient management provided by an EGS service line in response to consults from other hospital providers. This is a retrospective descriptive study of all adult patients with an EGS consult request placed from July 1, 2014 to June 30, 2016 at a 1000-bed tertiary referral center. Consult requests were classified by suspected diagnosis and linked to patient demographic and clinical information. Operative and nonoperative cases were compared. About 4998 EGS consults were requested during the 2-y period, of which 69.6% were placed on the first day of the patient encounter. Disposition outcomes after consultation included admission to the EGS service (27.6%) and discharge from the emergency department (25.3%). Small bowel obstruction, appendicitis, and cholecystitis decisively comprised the top three diagnoses for overall consults and those requiring admission to the EGS service. For every consult requiring an operation (n = 1400), 2.6 consults were managed without an operation (n = 3598). EGS surgeons are asked to evaluate and manage a variety of potentially surgical diagnoses. As most consults do not require surgical intervention, operative volume is a poor surrogate for quantifying EGS productivity. The role of this service is vital to patient triage and disposition, particularly in the emergency department setting. Institutions should consider the volume of their nonoperative consultations when evaluating EGS service line workload and in guiding staffing needs. •EGS consults are almost three times as likely to be managed non-operatively than operatively.•The role of EGS services is vital to patient triage and disposition, particularly in the ED setting.•EGS workload is dependent on operations as well as consult volume.