OBJECTIVE: We set out to assess if the ASAU improved care provided to patients with AA compared to those managed through the ED.
METHODS: Patients admitted via the ED with AA in the 6 months prior to opening the ASAU were compared to those admitted via the ASAU in the first six months following its implementation. Relevant data was collected on key performance indicators from their charts.
RESULTS: In the ASAU cohort, the mean time to be seen was one hour less than the ED cohort (21 min vs 74 min). The mean time to surgery was also 8.8 h shorter. Most patients in the ASAU group (78.6%) underwent surgery during the day, compared to 40.3% of ED patients. The ASAU patients also had a lower postoperative complication rate (0.9% vs 3.9%), as well as a lower negative appendicectomy rate (14.2% vs 18.6%) and lower conversion-to-open surgery rate. Greater consultant supervision and presence was observed.
CONCLUSIONS: The ASAU has resulted in better outcomes for patients with AA than those admitted via ED. More operations were performed in safer daytime hours with greater consultant presence, allowing for improved senior support for trainee surgeons. Our study supports the role of the ASAU in improving the quality and efficiency of emergency general surgery.
目的:我们着手评估与通过ED管理的患者相比,ASAU是否改善了对AA患者的护理。
方法:将打开ASAU前6个月内通过ED接受AA的患者与实施ASAU后的前6个月内通过ASAU接受的患者进行比较。从其图表中收集了关键绩效指标的相关数据。
结果:在ASAU队列中,平均观察时间比ED队列少1小时(21分钟vs74分钟).平均手术时间也短了8.8h。ASAU组的大多数患者(78.6%)在白天接受手术,相比之下,有40.3%的ED患者。ASAU患者术后并发症发生率也较低(0.9%vs3.9%),以及较低的阴性阑尾切除术率(14.2%vs18.6%)和较低的中转开放手术率。观察到更大的顾问监督和存在。
结论:与通过ED入院的患者相比,ASAU对AA患者的预后更好。在更安全的白天时间进行了更多的手术,有更多的顾问在场,允许改善对实习外科医生的高级支持。我们的研究支持ASAU在提高急诊普外科手术的质量和效率中的作用。