The acute surgical unit as a novel model of care for patients presenting with acute cholecystitis

The Medical Journal of Australia
Lester PepingcoMichael R Cox

Abstract

To determine whether the introduction of an acute surgical unit (ASU) resulted in a greater proportion of patients with acute cholecystitis receiving definitive surgery on index admission with no adverse change in surgical outcomes. A retrospective study of medical records for patients presenting to Nepean Hospital with acute cholecystitis during the 2 years before and 2 years after introduction of an ASU in November 2006. Time to diagnosis, timing of surgical intervention, surgical outcomes, duration of total admission and complication rates. A total 271 patients were included in the study (114 pre-ASU, 157 post-ASU). After introduction of the ASU, a higher proportion of patients had surgery on index admission (89.8% v 55.3%; P < 0.001) and there were decreases in median time to diagnosis (14.9 h v 10.8 h; P = 0.008), median time to definitive procedure (5.6 days v 2.1 days; P < 0.001), median duration of total admission (4.9 days v 4.0 days; P = 0.002), rate of intraoperative conversion to open surgery (14.9% v 4.5%; P = 0.003) and rate of postoperative infection (3.5% v 2.5%; P = 0.40). Introduction of the ASU at Nepean Hospital resulted in significant improvements in care and outcomes for patients with acute cholecystitis.

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Citations

Oct 23, 2015·The British Journal of Surgery·R ShakerianA R Skandarajah
Nov 6, 2012·ANZ Journal of Surgery·Douglas A StupartShannon Ryan
Apr 27, 2013·ANZ Journal of Surgery·David A K Watters, Philip G Truskett
Nov 30, 2013·ANZ Journal of Surgery·Dean E PageDhan Thiruchelvam
Aug 25, 2015·World Journal of Surgery·Rose ShakerianBenjamin Thomson
May 15, 2015·Langenbeck's Archives of Surgery·Rahul S KotiBrian R Davidson
Mar 10, 2015·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Amy M CaoMichael R Cox
Jun 30, 2016·Singapore Medical Journal·Sachin MathurKenneth Seck Wai Mak
Jul 7, 2017·ANZ Journal of Surgery·Ned KinnearGreg Otto
Jul 8, 2019·ANZ Journal of Surgery·Zhen Hao AngPhilip Truskett
Jan 17, 2020·ANZ Journal of Surgery·Cigdem KayaPhilip G Truskett
Oct 1, 2019·Trauma Surgery & Acute Care Open·Emily FletcherAkpofure Peter Ekeh
Dec 19, 2015·ANZ Journal of Surgery·Natasha PritchardWei Ming Ooi
Nov 10, 2016·Annals of Surgery·Patrick B MurphyUNKNOWN Western Ontario Research Collaborative on Acute Care Surgery.
Sep 13, 2018·ANZ Journal of Surgery·Zacharia T BazziGreg Otto
Feb 6, 2020·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·Si Ning Serene GohJerry Tiong Thye Goo
May 8, 2020·World Journal of Surgery·Mats J L van der WeeRigo Hoencamp
Jun 17, 2020·The Journal of Trauma and Acute Care Surgery·Omar Al BusaidiChad G Ball
May 4, 2017·World Journal of Emergency Surgery : WJES·Patrick B MurphyUNKNOWN Western Ontario Research Collaborative on Acute Care Surgery
Apr 17, 2019·ANZ Journal of Surgery·Ned KinnearJames Moore
Jul 12, 2021·Irish Journal of Medical Science·Enda Hannan, Sherif El-Masry

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