Xiehe Yixue Zazhi (Mar 2023)
Role of Establishing General Surgery Emergency Surgical Team in Improving the Work Efficiency of Emergency Surgery
Abstract
Objective To explore the role of establishing general surgical emergency team in improving the efficiency of emergency surgical treatment. Methods All patients attending emergency surgery from August1, 2019 to July 31, 2021 were retrospectively analysed. The number of flow, observation and their ratio before and after the establishment of general surgical emergency team were compared. The clinical data, including age, gender, complication, diagnoses, the number of surgery, the grading of disease, preoperative preparation time, the ratio of transfer to ICU, the ratio of patients staying more than 30 days, and complication rate before and after the establishment were analysed. Length of stay and hospitalization costs were compared by surgical grading and disease severity grading. The factors affecting hospitalization costs in emergency surgery patients were analysed using univariate and multiple linear regression. Results A total of 37 945 flow patients were included. Before and after the establishment of the surgical team, the number of flow was 15 745 and 22 200, respectively (1312 and 1850 monthly), the number of observation was 1814 and 1622, respectively (151 and 135 monthly), and the ratio of observation to flow decreased from 11.6% to 7.3% (P=0.000), preoperative preparation time decreased from (1.5±0.7) days to (0.7±0.9) days (P=0.000), the ratio of transfer to ICU decreased from 37.9% to 23.7% (P=0.000), the ratio of patients staying more than 30 days decreased from 5.7% to 0.5% (P=0.000), the average length of stay (5 d vs. 3 d, P=0.028) and cost (34 000 vs. 13 000, P=0.000) were significantly reduced, and the total operation number were 317 and 919, respectively(26 vs. 77 monthly, P=0.000).There was no significant change in complication rate (P=0.548). Multiple linear regression showed that establishing emergency surgery team reduced the hospitalization cost, while high surgical grading, long hospitalization time and transfer to ICU increased the hospitalization cost. Conclusion The establishment of emergency surgery team can solve the current problem of emergency to some degree, such as evacuating emergency congestion, increasing emergency surgery turnover rate, reducing the medical burden, and improving the efficiency of emergency treatment.
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