Yi Gun-Hee, Hong Suk-Kyung, Jun Yang-Hee, Yoo Sungyeon, Bae Jung-Min, Yoo Keesang, Jung Yun Tae, Kim EunYoung, Lee Narae, Ko Min Jung, Shin Hogyun, Lee Hak-Jae
Division of Acute Care Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Department of Surgery, Yeungnam University College of Medicine, Daegu, Korea.
ANZ J Surg. 2025 Mar;95(3):416-422. doi: 10.1111/ans.19366. Epub 2024 Dec 17.
In emergency general surgery (EGS), rapid judgement and prompt emergency surgery play a significant role in determining the patient's prognosis. This study aimed to evaluate whether implementing the acute care surgery (ACS) system in Korea has improved the clinical outcomes of patients.
This retrospective cohort study was conducted at three tertiary hospitals in Korea. The study included patients aged 18-99 years who required EGS due to acute abdomen or abdominal trauma. A window period of 4 months was set after the implementation of the ACS system, and the clinical outcomes before and after the implementation were compared.
A total of 2146 patients were enrolled in the study, with 1008 in the pre-ACS group and 1138 in the post-ACS group. After propensity score matching, 901 patients were selected in the pre-ACS group and 906 patients were selected in the post-ACS group. The time from emergency room admission to operating room transfer was reduced in the post-ACS group, with a mean of 452.2 ± 347.0 min compared to 522.1 ± 416.5 min in the pre ACS group (P = 0.001). Moreover, the complication rates were reduced in the post-ACS group (38.3% vs. 31.3%, P = 0.006).
The implementation of the ACS system can lead to faster surgical decision-making and the prompt execution of emergency surgery for patients, thereby reducing postoperative complications.
在急诊普通外科（EGS）中，快速判断和及时的急诊手术在决定患者预后方面起着重要作用。本研究旨在评估在韩国实施急性护理手术（ACS）系统是否改善了患者的临床结局。
这项回顾性队列研究在韩国的三家三级医院进行。研究纳入了因急腹症或腹部创伤而需要进行急诊普通外科手术的18至99岁患者。在实施ACS系统后设定了4个月的观察期，并比较了实施前后的临床结局。
共有2146例患者纳入研究，ACS实施前组1008例，ACS实施后组1138例。经过倾向评分匹配后，ACS实施前组选择了901例患者，ACS实施后组选择了906例患者。ACS实施后组从急诊室入院到手术室转运时间缩短，平均为452.2±347.0分钟，而ACS实施前组为522.1±416.5分钟（P = 0.001）。此外，ACS实施后组的并发症发生率降低（38.3%对31.3%，P = 0.006）。
实施ACS系统可使手术决策更快，并能为患者及时实施急诊手术，从而减少术后并发症。
