scholarly journals Patterns of complex emergency general surgery in Canada

2020 ◽  
Vol 63 (5) ◽  
pp. E435-E441
Author(s):  
Kelly N. Vogt ◽  
Laura Allen ◽  
Patrick B. Murphy ◽  
Rardi van Heest ◽  
Fady Saleh ◽  
...  
Keyword(s):  
General Surgery ◽  
Emergency General Surgery ◽  
Complex Emergency

Appraising the Quality of Reporting of American College of Surgeons NSQIP Emergency General Surgery Studies

2021 ◽  
Vol 232 (5) ◽  
pp. 671-680 ◽  
Author(s):  
Mohamad El Moheb ◽  
Hadi Sabbagh ◽  
Daniel Badin ◽  
Tala Mahmoud ◽  
Basil Karam ◽  
...  
Keyword(s):  
General Surgery ◽  
Emergency General Surgery ◽  
Quality Of Reporting ◽  
American College Of Surgeons

scholarly journals 892 Emergency General Surgical Practice at a District General Hospital during COVID-19 Pandemic: Implementing Royal College of Surgeons Guidance

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
K Hashmi ◽  
S Khalid ◽  
K Raja ◽  
A Zaka ◽  
J Easterbrook
Keyword(s):  
Informed Consent ◽  
Royal College ◽  
Mortality Risk ◽  
General Surgery ◽  
Surgical Care ◽  
District General Hospital ◽  
Emergency General Surgery ◽  
Surgical Practice ◽  
Full Compliance ◽  
Type Of Surgery

Abstract Introduction COVID-19 pandemic had a significant impact on surgical practice across NHS. RCS released guidance on altering surgical practise during the pandemic to deliver safe surgical care in March, 2020. We present an audit conducted at a DGH comparing practice of emergency general surgery (EGS) with RCS guidance at the peak of COVID-19 pandemic. Method Consecutive patients undergoing EGS from 1st April to 15th May,2020. Data of demographics, ASA grade, comorbidities, type of surgery, hospital stay, informed COVID-19 pneumonia consent, complications and 30-day mortality were collected. Pre- and post-operative COVID-19 status was determined. Results Forty-four (n = 44) patients, mean age 47.5 and IQR (26-69). Male (55.8%) and females (44.2%). Preoperative COVID19 status was confirmed in around 79.1% patients. All (100%) patients who underwent CT imaging preoperatively had CT chest performed. Informed consent for COVID19 pneumonia was taken in 4.7% patients. 30-day mortality risk was 7% and complications risk was 4.7%. RR of 30-day mortality in preoperative COVID19 status positive patients was RR = 0.92 (CI 0.85-1.01) and for complications was RR = 0.95 (CI 0.88-1.02). Conclusions RCS guidance on managing and altering practice in EGS during COVID-19 pandemic is reliable, implementable, and measurable in a DGH setting. Simple improvements in consent process can achieve full compliance with RCS guidelines.

The Obesity Paradox in Emergency General Surgery Patients

2021 ◽  
pp. 000313482096852
Author(s):  
Sean R. Maloney ◽  
Caroline E. Reinke ◽  
Abdelrahman A. Nimeri ◽  
Sullivan A. Ayuso ◽  
A. Britton Christmas ◽  
...  
Keyword(s):  
General Surgery ◽  
Multivariable Analysis ◽  
Operative Management ◽  
Chronic Obstructive ◽  
High Morbidity ◽  
Emergency General Surgery ◽  
Common Procedure ◽  
Increased Risk ◽  
Social Security Death Index ◽  
The Impact

Operative management of emergency general surgery (EGS) diagnoses involves a range of procedures which can carry high morbidity and mortality. Little is known about the impact of obesity on patient outcomes. The aim of this study was to examine the association between body mass index (BMI) >30 kg/m2 and mortality for EGS patients. We hypothesized that obese patients would have increased mortality rates. A regional integrated health system EGS registry derived from The American Association for the Surgery of Trauma EGS ICD-9 codes was analyzed from January 2013 to October 2015. Patients were stratified into BMI categories based on WHO classifications. The primary outcome was 30-day mortality. Longer-term mortality with linkage to the Social Security Death Index was also examined. Univariate and multivariable analyses were performed. A total of 60 604 encounters were identified and 7183 (11.9%) underwent operative intervention. Patient characteristics include 53% women, mean age 58.2 ± 18.7 years, 64.2% >BMI 30 kg/m2, 30.2% with chronic obstructive pulmonary disease, 19% with congestive heart failure, and 31.1% with diabetes. The most common procedure was laparoscopic cholecystectomy (36.4%). Overall, 90-day mortality was 10.9%. In multivariable analysis, all classes of obesity were protective against mortality compared to normal BMI. Underweight patients had increased risk of inpatient (OR = 1.9, CI = 1.7-2.3), 30-day (OR = 1.9, CI = 1.7-2.1), 90-day (OR = 1.8, CI 1.6-2.0), 1-year (OR = 1.8, CI = 1.7-2.0), and 3-year mortality (OR = 1.7, CI = 1.6-1.9). When stratified by BMI, underweight EGS patients have the highest odds of death. Paradoxically, obesity appears protective against death, even when controlling for potentially confounding factors. Increased rates of nonoperative management in the obese population may impact these findings.

Emergency General Surgery in the Elderly: Too Old or Too Frail?

2014 ◽  
Vol 219 (3) ◽  
pp. S53-S54 ◽  
Author(s):  
Bellal Joseph ◽  
Viraj Pandit ◽  
Bardiya Zangbar ◽  
Narong Kulvatunyou ◽  
Andrew L. Tang ◽  
...  
Keyword(s):  
General Surgery ◽  
The Elderly ◽  
Emergency General Surgery ◽  
Surgery In The Elderly

Emergency General Surgery in Older Patients: A National Comparison of Presentation and Outcomes

2014 ◽  
Vol 219 (3) ◽  
pp. S52-S53
Author(s):  
Syed Nabeel Zafar ◽  
Adil A. Shah ◽  
Zain G. Hashmi ◽  
Aftab Iqbal ◽  
Wendy R. Greene ◽  
...  
Keyword(s):  
General Surgery ◽  
Older Patients ◽  
Emergency General Surgery ◽  
National Comparison

Never giving up: outcomes and presentation of emergency general surgery in geriatric octogenarian and nonagenarian patients

2016 ◽  
Vol 212 (2) ◽  
pp. 211-220.e3 ◽  
Author(s):  
Adil A. Shah ◽  
Syed Nabeel Zafar ◽  
Lisa M. Kodadek ◽  
Cheryl K. Zogg ◽  
Alyssa B. Chapital ◽  
...  
Keyword(s):  
General Surgery ◽  
Emergency General Surgery
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