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응급수술팀 모델 도입이 응급수술 결과에 미치는 영향

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Alternative Title
Outcomes in emergency surgery following the implementation of an acute care surgery model : Retrospective observational study
Abstract
Background
Over the past three years, approximately 23,000 emergency surgeries were performed
annually in South Korea, accounting for > 1% of all surgeries nationwide. With the
growing necessity for treating these emergency cases with dedication and proficiency,
acute care surgery (ACS) teams were appointed at various hospitals. Regarding the
implications of the ACS team, many studies showed promising results with a shorter
time from the emergency department (ED) to the operating room (OR), shorter length
of stay, and fewer complications. This study aimed to demonstrate the overall effect of
ACS implementation at a single institution in South Korea.
Methods
This was a single-center, retrospective observational study. Patients aged > 18 years
who visited the ER and received emergency surgery between July 2014 and December
2016 (Pre-ACS) and between July 2017 and December 2019 (Post-ACS) were included.
Results
Among 958 patients, 497 were in the pre-ACS group and 461 in the post-ACS group.
After propensity score matching by age, sex, underlying disease, and emergency surgery
acuity score, 405 patients remained in each group. Although our analysis showed no
significant differences in mortality between the pre-ACS and the post-ACS group (2.4%
vs 3.4%, P = 0.408, respectively), it showed a reduction in time from ED presentation to
operation (547.8 ± 401.0 vs. 476.6 ± 313.2 minutes, P = 0.005) and complication rates
(24.7% vs. 16.8%, P < 0.001). There were no significant differences in total operation
duration and length of hospital stay.
Conclusions
Although mortality was not reduced in the post-ACS group as expected, time from ED
to OR and complication rates were significantly reduced in the post-ACS group. We can
state that implementing an ACS team dedicated to emergency surgery provides safe
and better clinical outcomes.
Author(s)
유성언
Issued Date
2024
Awarded Date
2024-08
Type
Dissertation
Keyword
Acute Care Surgery
URI
https://oak.ulsan.ac.kr/handle/2021.oak/13313
http://ulsan.dcollection.net/common/orgView/200000808147
Alternative Author(s)
Yoo Sungyeon
Affiliation
울산대학교
Department
일반대학원 의학과
Advisor
홍석경
Degree
Master
Publisher
울산대학교 일반대학원 의학과
Language
eng
Rights
울산대학교 논문은 저작권에 의해 보호받습니다.
Appears in Collections:
Medicine > 1. Theses (Master)
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