Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/19593
Title: Impact of an acute surgical unit on outcomes in acute cholecystitis.
Authors: Bazzi, Zacharia T;Kinnear, Ned J;Bazzi, Ciara S;Hennessey, Derek B;Henneberg, Maciej;Otto, Greg
Affiliation: Department of Surgery, Lyell McEwin Hospital, Adelaide, South Australia, Australia
Department of Surgery, Modbury Hospital, Adelaide, South Australia, Australia
Department of Urology, Austin Health, Heidelberg, Victoria, Australia
Department of Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia
Issue Date: 11-Sep-2018
EDate: 2018-09-11
Citation: ANZ Journal of Surgery 2018; online first: 11 September
Abstract: The acute surgical unit (ASU) model has been associated with improved outcomes for emergency general surgical patients. Few Australasian studies have investigated patients with cholecystitis and none from South Australia. A retrospective cohort study compared patients admitted to our institution with acute cholecystitis during the 2 years before (traditional period) and after (ASU period) introduction of an ASU on 1 August 2012. Primary outcomes were length of stay, rates of definitive surgery on index admission, time to definitive surgery and proportion of cases performed in-hours. Secondary outcomes were time from emergency department referral to admission, time from radiologically confirmed diagnosis to theatre start, rates of conversion to open cholecystectomy, complications and cholelithiasis-related representations while awaiting definitive procedure. A total of 319 patients met the inclusion criteria; 172 and 147 pre- and post-ASU introduction, respectively. Compared with the traditional period, ASU patients had shorter length of stay (3.80 versus 2.83 days, P < 0.0001), higher rates of surgery on index admission (70.9% versus 95.3%, P < 0.0001), shorter time to definitive surgery (28.1 versus 22.1 days, P < 0.001), lower rates of conversion to open cholecystectomy (18.0% versus 7.1%, P = 0.007) and fewer complications (24.4% versus 6.1%, P < 0.0001). Other outcomes were not significantly different. Introduction of an ASU was associated with superior outcomes amongst patients admitted with acute cholecystitis. These findings extend the literature in support of the current model of care.
URI: http://ahro.austin.org.au/austinjspui/handle/1/19593
DOI: 10.1111/ans.14802
ORCID: 0000-0002-7833-2537
0000-0002-7372-0100
PubMed URL: 30207047
Type: Journal Article
Subjects: acute surgical unit
cholecystectomy
cholecystitis
emergency surgery
general surgery
Appears in Collections:Journal articles

Files in This Item:
There are no files associated with this item.


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.