Department of Surgery, Aberdeen Royal Infirmary, Aberdeen, United Kingdom.
Department of Surgery, University of Aberdeen, Aberdeen, United Kingdom.
Ann Surg. 2020 Mar;271(3):581-589. doi: 10.1097/SLA.0000000000003066.
The aim of the study was to evaluate secular trends in the epidemiology of emergency general surgery (EGS), by analyzing changes in demographics, diagnoses, operations, and outcomes between 1997 and 2016.
The provision and delivery of EGS services is a globally and regionally important issue. The impact of changing demographics and surgical disease incidence on EGS services is not well understood.
Data from all EGS hospital episodes of adults (aged >15) in Scotland between 1997 and 2016 were prospectively collected, including ICD-10 diagnostic codes and OPCS-4 procedure codes. The number and age- and sex-standardized rates per 100,000 population, per year, of the most common diagnoses and operations were calculated. We analyzed demographic changes over time using linear regression, and changes in characteristics, diagnoses, operations, and outcomes using Poisson analysis.
Data included 1,484,116 EGS hospital episodes. The number and age- and sex-standardized rate, per 100,000 population, of EGS admissions have increased over time, whereas that of EGS operations have decreased over time. Male admissions were unchanged, but with fewer operations over time, whereas female admissions increased significantly over time with no change in the operation rate. Poisson analysis demonstrated secular trends in demographics, admissions, operations, and outcomes in depth.
This 20-year epidemiological study of all EGS hospital episodes in Scotland has enhanced our understanding of secular trends of EGS, including demographics, diagnoses, operations, and outcomes. These data will help inform stakeholders in EGS service planning and delivery, as well as in surgical training, what has occurred in recent history.
本研究旨在通过分析 1997 年至 2016 年间的人口统计学、诊断、手术和结局变化，评估急诊普通外科（EGS）的流行病学的长期趋势。
EGS 服务的提供和交付是一个全球性和区域性的重要问题。人口统计学变化和外科疾病发病率对 EGS 服务的影响尚不清楚。
前瞻性收集了 1997 年至 2016 年苏格兰所有成人（年龄>15 岁）EGS 住院患者的数据，包括 ICD-10 诊断代码和 OPCS-4 手术代码。计算了最常见诊断和手术的每年每 10 万人的数量和年龄及性别标准化率。我们使用线性回归分析了随时间变化的人口统计学变化，并使用泊松分析分析了特征、诊断、手术和结局的变化。
数据包括 1484116 例 EGS 住院患者。EGS 入院的数量和年龄及性别标准化率，每年每 10 万人，随时间增加，而 EGS 手术的数量随时间减少。男性入院人数不变，但手术次数随时间减少，而女性入院人数显著增加，手术率不变。泊松分析深入地显示了人口统计学、入院、手术和结局的长期趋势。
这项对苏格兰所有 EGS 住院患者的 20 年流行病学研究增强了我们对 EGS 的长期趋势的理解，包括人口统计学、诊断、手术和结局。这些数据将有助于告知 EGS 服务规划和提供以及外科培训的利益相关者，了解最近发生的情况。
