Division of Critical Care, Department of Surgery, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Korea.
Division of Acute Care Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Medicine (Baltimore). 2024 Jul 19;103(29):e38927. doi: 10.1097/MD.0000000000038927.
We conducted this study to assess the effects of the acute care surgery (ACS) model in the management of patients with acute appendicitis (AA) based on our 5-year single-center, retrospective experience. The current single-center, retrospective, observational study was conducted in a consecutive series of the patients with AA who had been surgically treated at a tertiary referral hospital in Seoul, Korea, between January 2016 and December 2020. At our institution, the ACS model was first introduced in March 2018. Therefore, our clinical series of the patients were divided into 2 groups: the pre-ACS group (March 2014 to February 2018) and the post-ACS group (March 2018 to December 2022). Key time intervals include emergency department registration to request for surgical consultation, request for surgical consultation to decision on surgery, decision-to-operating room, time to decision on surgery and length of emergency department stay. Moreover, outcomes include rates of perforation and complications and discharge within 24 or 48 hours. We compared key time intervals, outcomes, and length of hospital stay between the 2 groups. A total of 900 patients with AA were finally included in the current study, 447 and 453 of whom were divided into the pre-ACS group (n = 447) and the post-ACS group (n = 453), respectively. There were significant differences in key time intervals, outcomes, and length of hospital stay between the 2 groups (P < .05). In conclusion, our results showed that the implementation of the ACS model was effective in improving key time intervals, rates of perforation, and discharge within 24 or 48 hours in the patients with AA.
我们进行这项研究,旨在根据我们 5 年的单中心回顾性经验,评估急性护理外科 (ACS) 模式在急性阑尾炎 (AA) 患者管理中的作用。本单中心回顾性观察研究纳入了 2016 年 1 月至 2020 年 12 月期间在韩国首尔一家三级转诊医院接受手术治疗的 AA 连续系列患者。在我们的机构中,ACS 模式于 2018 年 3 月首次引入。因此,我们的患者临床系列分为 2 组:ACS 前组(2014 年 3 月至 2018 年 2 月)和 ACS 后组(2018 年 3 月至 2022 年 12 月)。关键时间间隔包括急诊登记请求手术咨询、请求手术咨询至决定手术、决定手术至手术室、决定手术时间和急诊停留时间。此外,结果包括穿孔率和并发症发生率以及 24 或 48 小时内出院率。我们比较了两组之间的关键时间间隔、结果和住院时间。共有 900 例 AA 患者最终纳入本研究,其中 447 例和 453 例患者分别分为 ACS 前组(n=447)和 ACS 后组(n=453)。两组之间的关键时间间隔、结果和住院时间存在显著差异(P<0.05)。总之,我们的结果表明,ACS 模式的实施有效改善了 AA 患者的关键时间间隔、穿孔率和 24 或 48 小时内出院率。