Please use this identifier to cite or link to this item:
Scopus Web of Science® Altmetric
Type: Journal article
Title: Acute surgical unit improves outcomes in appendicectomy
Author: Kinnear, N.
Bramwell, E.
Frazzetto, A.
Noll, A.
Patel, P.
Hennessey, D.
Otto, G.
Dobbins, C.
Sammour, T.
Moore, J.
Citation: ANZ Journal of Surgery, 2019; 89(9):1108-1113
Publisher: WILEY
Issue Date: 2019
ISSN: 1445-2197
Statement of
Ned Kinnear, Eliza Bramwell, Alannah Frazzetto, Amy Noll, Prajay Patel, Derek Hennessey, Greg Otto, Christopher Dobbins, Tarik Sammour and James Moore
Abstract: BACKGROUND: Few large Australian studies have explored the impact of acute surgical unit (ASU) model in appendicitis. METHODS: An ASU model commenced practice at our institution on 1 August 2012. In this retrospective cohort study, patients undergoing appendicectomy 2.5 years before (Traditional group) or after (ASU group) this date were compared. Primary outcomes were median length of stay, median time from emergency department referral to theatre start and proportion of cases performed in-hours. Secondary outcomes were rates of complications, open appendicectomy, consultant scrubbed for procedure, intensive care unit admission and re-presentation to emergency department within 30 days. RESULTS: After removing those with incomplete data, 1214 patients were enrolled; 465 in the Traditional group and 749 in the ASU group. There were no significant baseline differences between groups. Compared with the Traditional group, ASU patients had similar length of stay (1.81 versus 1.81 days; P = 0.54) and time to theatre (0.59 versus 0.56 days; P = 0.14), but a greater proportion of in-hours operation (72% versus 79%; P = 0.014). The ASU group also experienced fewer complications (9% versus 6%; P = 0.031), fewer primary open (4% versus 1%; P < 0.0001) or conversion-to-open appendicectomies (6% versus 2%; P < 0.0005) and had superior rates of consultant scrubbed in theatre (21% versus 56%; P < 0.00001). Rates of intensive care unit admission (1% versus 1%; P = 0.72) and re-presentation were unchanged (5% versus 5%; P = 0.46). CONCLUSION: In our institution, the introduction of an ASU model was associated with more in-hours operations and safer care for patients undergoing appendicectomy.
Keywords: Adult *Appendectomy Appendicitis/*surgery Cohort Studies Emergency Service, Hospital Female Humans Male Retrospective Studies *Surgery Department, Hospital Treatment Outcome Young Adult *acute care surgery *acute surgical unit *appendicectomy *appendicitis *emergency general surgery
Rights: © 2019 Royal Australasian College of Surgeons.
DOI: 10.1111/ans.15141
Appears in Collections:Aurora harvest 8
Surgery publications

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

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