Shaina Schaetzel1, Rachel Dirks2, James Davis2. 1. Department of Surgery, UCSF, 2823 Fresno St, 1st Floor, Fresno, CA, USA. Electronic address: shainadockter@yahoo.com. 2. Department of Surgery, UCSF, 2823 Fresno St, 1st Floor, Fresno, CA, USA.
Abstract
BACKGROUND: This study compared outcomes, patient flow, and cost between an acute care surgery (ACS) and traditional call model (TRAD) for acute appendicitis in the same community and time period. METHODS: Patients who underwent appendectomy from 7/1/2012 to 6/30/2014 were retrospectively reviewed. An ACS and TRAD were compared. Demographic data, outcomes, cost, and time intervals were compared. RESULTS: Of the 945 patients reviewed, the ACS group had more perforated appendicitis on preoperative computed tomography scan (9% vs 3%, P < .001) and pathology (23% vs 10%, P < .001). The TRAD group had more negative appendectomies (6% vs 1%, P < .001). In nonperforated appendicitis, time to discharge was shorter with ACS (16.4 vs 30.2 hours, P < .001), and mean cost was less (P < .001). Complications were similar. CONCLUSIONS: ACS was superior for management of acute appendicitis with shorter time from consultation to operation, shorter time to discharge if nonperforated, and decreased cost. Copyright Â
BACKGROUND: This study compared outcomes, patient flow, and cost between an acute care surgery (ACS) and traditional call model (TRAD) for acute appendicitis in the same community and time period. METHODS:Patients who underwent appendectomy from 7/1/2012 to 6/30/2014 were retrospectively reviewed. An ACS and TRAD were compared. Demographic data, outcomes, cost, and time intervals were compared. RESULTS: Of the 945 patients reviewed, the ACS group had more perforated appendicitis on preoperative computed tomography scan (9% vs 3%, P < .001) and pathology (23% vs 10%, P < .001). The TRAD group had more negative appendectomies (6% vs 1%, P < .001). In nonperforated appendicitis, time to discharge was shorter with ACS (16.4 vs 30.2 hours, P < .001), and mean cost was less (P < .001). Complications were similar. CONCLUSIONS:ACS was superior for management of acute appendicitis with shorter time from consultation to operation, shorter time to discharge if nonperforated, and decreased cost. Copyright Â