Comparative analysis of emergency general surgery on-call structure and its impact on emergency appendicectomy outcomes.

Abstract:

BACKGROUND:In Australia, there has been a shift from the traditional 'on-call' surgical model to the 'acute surgical unit' (ASU) model to improve outcomes in acute general surgery. Using emergency appendicectomy as a standardized procedure, we aimed to identify the different patterns of care between these on-call structures by comparing two metropolitan district hospitals; one that employs a traditional on-call model and the other, which employ the ASU model. METHODS:Data on consecutive patients undergoing emergency appendectomies at the two hospitals (traditional and ASU model) between July 2018 and December 2018 were retrieved for retrospective review. Patient factors, preoperative factors, operative factors and post-operative outcomes were collected and tabulated for comparative analysis between the traditional versus ASU model of care. RESULTS:Univariate analysis demonstrated that there were a greater proportion of consultant-led cases (P < 0.001), a shorter time to theatre (P = 0.047) and a greater number of out-of-hours operations (P < 0.001) in the ASU model compared to the traditional model. A larger proportion of patients from the traditional model underwent a computed tomography scan as part of their diagnostic workup compared to the ASU model (P < 0.001). There was no difference in negative appendicectomy rates, intraoperative conversion rates, post-operative complication rates or mean lengths of hospital stay between the two on-call models. CONCLUSION:The ASU and traditional on-call model appears to achieve equivalent care outcomes for patients with acute appendicitis.

journal_name

ANZ J Surg

journal_title

ANZ journal of surgery

authors

Gounder J,Dissanayake B,Burstow MJ,Yuide PJ,Naidu S,Lancashire RP,Chua TC

doi

10.1111/ans.16558

subject

Has Abstract

pub_date

2021-01-18 00:00:00

eissn

1445-1433

issn

1445-2197

pub_type

杂志文章
  • Acute forearm compartment syndrome following haemodialysis access fistula puncture in uraemia.

    abstract:BACKGROUND:Acute compartment syndrome is a well-described surgical emergency that requires immediate diagnosis and operative intervention. Vascular access-associated compartment syndrome is rarely reported in haemodialysis patients. The purpose of this article is to document evidence that catheter-related puncture, whi...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.12701

    authors: Lin CT,Dai NT,Chen SG,Chang SC

    更新日期:2016-10-01 00:00:00

  • Conservative approach is feasible in the management of acute diverticulitis of the right colon.

    abstract:BACKGROUND:Acute diverticulitis of the caecum and ascending colon is uncommon. Controversies abound as regards the optimal surgical treatment, ranging from appendectomy, diverticulectomy to right hemicolectomy. The aim of the present paper was to review treatment strategy followed by a critical appraisal. METHODS:The ...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1046/j.1445-1433.2001.2226.x

    authors: Chiu PW,Lam CY,Chow TL,Kwok SP

    更新日期:2001-11-01 00:00:00

  • The outcome of patients on the cholecystectomy waiting list in Western Australia 1999-2005.

    abstract:BACKGROUND:Surgeons are noticing increasing numbers of cholecystectomy waiting list patients presenting with complications of their gallstones. In this study, we analysed the outcome of these to ascertain natural history and outcome. METHODS:Data for 5298 waiting list patients in Western Australia, from 1999 to 2006, ...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/j.1445-2197.2010.05428.x

    authors: Epari KP,Mukhtar AS,Fletcher DR,Samarasam I,Semmens JB

    更新日期:2010-10-01 00:00:00

  • Assessment of myocardial injury by troponin T in off-pump coronary artery grafting and conventional coronary artery graft surgery.

    abstract:PURPOSE:The present study was undertaken to assess the degree of myocardial injury, using troponin T (TnT), in off-pump coronary artery surgery (OPCAB) and in a comparable patient group undergoing conventional coronary artery graft surgery (CABG). METHODS:Twenty-seven OPCAB and 27 CABG patients were investigated. Bloo...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1046/j.1445-2197.2002.02317.x

    authors: Bennetts JS,Baker RA,Ross IK,Knight JL

    更新日期:2002-02-01 00:00:00

  • Reduction in hospital admissions with an early computed tomography scan: results of an outpatient management protocol for uncomplicated acute diverticulitis.

    abstract:BACKGROUND:There is increasing evidence that uncomplicated acute diverticulitis (UAD) can be safely and effectively managed as an outpatient. The aim of the current study was to evaluate if an early computed tomography (CT) scan in the emergency department (ED) can reduce the number of hospital admissions when UAD is d...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.15285

    authors: Juszczyk K,Ireland K,Thomas B,Kroon HM,Hollington P

    更新日期:2019-09-01 00:00:00

  • Patterns of polyp histology: predictors of peril in the mucosa.

    abstract:BACKGROUND:Precursor colonic polyps of varied subtypes correlate with the known neoplastic pathways. When patients present with synchronous pre-malignant polyps of multiple histologies, multiple genetic mechanisms are likely to be active, potentially resulting in a more unstable, tumourigenic mucosa. METHODS:We hypoth...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.15662

    authors: Dean M,Plesec T,Kalady MF,Church J

    更新日期:2020-05-01 00:00:00

  • Prospective comparison of return of bowel function after left versus right colectomy.

    abstract:BACKGROUND:Passage of flatus and stool represents a key milestone in recovery after colonic resections. Colorectal surgeons may hold varied expectations regarding recovery rates after left- versus right-sided colectomies, but there is currently little evidence to inform post-operative care. This study prospectively com...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/ans.13823

    authors: Yuan L,O'Grady G,Milne T,Jaung R,Vather R,Bissett IP

    更新日期:2018-04-01 00:00:00

  • Paediatric appendicitis: increased disease severity and complication rates in rural children.

    abstract:BACKGROUND:Appendicitis is the most common surgical emergency affecting children. Rurality has been shown to be a predictor of worse surgical outcomes in patients with acute appendicitis compared to urban residents. There are no previously published studies investigating this in Australasia. METHODS:A 10-year retrospe...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.15328

    authors: Elliott BM,Witcomb Cahill H,Harmston C

    更新日期:2019-09-01 00:00:00

  • Systematic review of the impact of sacral neuromodulation on clinical symptoms and gastrointestinal physiology.

    abstract:BACKGROUND:Sacral neuromodulation (SNM) has emerged as a treatment option for faecal incontinence (FI). However, its objective effect on symptoms and anorectal function is inconsistently described. This study aimed to systematically review the impact of SNM on clinical symptoms and gastrointestinal physiology in patien...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章,评审

    doi:10.1111/ans.13257

    authors: Mirbagheri N,Sivakumaran Y,Nassar N,Gladman MA

    更新日期:2016-04-01 00:00:00

  • Impact of COVID-19-related social restrictions on orthopaedic trauma in a level 1 trauma centre in Sydney: the first wave.

    abstract:BACKGROUND:The coronavirus disease 2019 (COVID-19) pandemic has affected communities worldwide. This study examines the impact that public health measures to control viral spread have had on orthopaedic trauma presenting to an Australian level 1 trauma centre. We hypothesized that the volume of orthopaedic trauma in th...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.16375

    authors: Probert AC,Sivakumar BS,An V,Nicholls SL,Shatrov JG,Symes MJ,Ellis AM

    更新日期:2020-10-13 00:00:00

  • Case cancellations on the day of surgery: an investigation in an Australian paediatric hospital.

    abstract:BACKGROUND:This study investigates case cancellations on the intended day of surgery (DOS) at a paediatric hospital in Melbourne, Australia. The hospital in Melbourne treats over 32 000 inpatients annually and handles both elective and emergency cases. METHODS:The data for this paper were collected over a period of 12...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/j.1445-2197.2009.05019.x

    authors: Haana V,Sethuraman K,Stephens L,Rosen H,Meara JG

    更新日期:2009-09-01 00:00:00

  • Validation of data submitted by the treating surgeon in the Victorian Audit of Surgical Mortality.

    abstract:BACKGROUND:The Victorian Audit of Surgical Mortality (VASM) seeks to peer review all deaths associated with surgical care in Victoria, Australia. The effectiveness of the VASM as an educational and quality improvement tool is dependent on the accuracy of source data it receives. We aimed to examine the accuracy and qua...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.14910

    authors: Hansen D,Hansen E,Retegan C,Morphet J,Beiles CB

    更新日期:2019-01-01 00:00:00

  • Comparison between video-assisted retroperitoneal debridement and small incision pancreatic necrosectomy in infected pancreatic necrosis.

    abstract:BACKGROUND:Debridement and drainage have always been mainstream treatment for infected pancreatic necrosis (IPN), and the application of minimally invasive necrosectomy is becoming increasingly widespread. However, few studies have compared video-assisted retroperitoneal debridement (VARD) and small incision pancreatic...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.16181

    authors: Zhang JB,Sun B

    更新日期:2020-08-11 00:00:00

  • Morgagni's hernia: believing is seeing.

    abstract::The original description by Morgagni of the anterior diaphragmatic defect that bears his name implies a paramedian defect and this may be true when acquired in adulthood. In contrast, the anterior diaphragmatic defect that is observed in children is central rather than paramedian, as is often assumed. Its central retr...

    journal_title:ANZ journal of surgery

    pub_type: 传,历史文章,杂志文章

    doi:10.1111/j.1445-2197.2008.04641.x

    authors: McBride CA,Beasley SW

    更新日期:2008-09-01 00:00:00

  • Long-term venous access insertion: 'the learning curve'.

    abstract:BACKGROUND:The central venous access port device (CVAPD) provides reliable vascular access and is used for delivery of fluids and for obtaining blood samples. However, it can carry some intra- and post-operative complications such as thrombosis, pneumothorax, catheter fracture and port malposition. This article describ...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.13338

    authors: Fosh B,Canepa M,Eaton M

    更新日期:2016-12-01 00:00:00

  • Protocol-based approach to suspected appendicitis, incorporating the Alvarado score and outpatient antibiotics.

    abstract:BACKGROUND:There is evidence that antibiotics can be used as primary treatment for appendicitis, however, delayed surgical treatment might still be associated with perforation. Most patients at risk of perforation have high Alvarado scores. We designed a protocol-based approach to suspected appendicitis, in which the A...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/j.1445-1433.2004.02993.x

    authors: Winn RD,Laura S,Douglas C,Davidson P,Gani JS

    更新日期:2004-05-01 00:00:00

  • Severe trauma caused by stabbing and firearms in metropolitan Sydney, New South Wales, Australia.

    abstract:BACKGROUND:Stabbing and firearm trauma causing severe injuries (injury severity score (ISS) >15) and death is uncommon in Australia. The present study describes the experience with stabbings and firearm trauma causing severe injuries at a major Australian urban trauma centre. METHODS:Data from a prospectively generate...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/j.1445-2197.2005.03333.x

    authors: Wong K,Petchell J

    更新日期:2005-04-01 00:00:00

  • Neutrophil-to-lymphocyte ratio predicts anastomotic dehiscence.

    abstract:BACKGROUND:Anastomotic dehiscence (AD) is the most feared complication following colonic and rectal anastomosis. Multiple attempts have been made to correlate the levels of biomarkers to the risk of AD. This study attempts to compare C-reactive protein (CRP), procalcitonin (PCT) and neutrophil-to-lymphocyte ratio (NLR)...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.14369

    authors: Walker PA,Kunjuraman B,Bartolo DCC

    更新日期:2018-01-27 00:00:00

  • Bach and His.

    abstract::This paper examines the career of Johann Sebastian Bach (1685-1750) and the role played by Wilhelm His I (who was, with Albert von Haller, a noted pioneer of physiology) in the exhumation of Bach's remains in 1894. His's examination of these remains allowed the sculptor Carl Seffner to produce the celebrated statue of...

    journal_title:ANZ journal of surgery

    pub_type: 传,历史文章,杂志文章

    doi:10.1111/ans.12398

    authors: Beasley W

    更新日期:2014-12-01 00:00:00

  • Use of face masks by non-scrubbed operating room staff: a randomized controlled trial.

    abstract:BACKGROUND:Ambiguity remains about the effectiveness of wearing surgical face masks. The purpose of this study was to assess the impact on surgical site infections (SSIs) when non-scrubbed operating room staff did not wear surgical face masks. METHODS:Eight hundred twenty-seven participants undergoing elective or emer...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/j.1445-2197.2009.05200.x

    authors: Webster J,Croger S,Lister C,Doidge M,Terry MJ,Jones I

    更新日期:2010-03-01 00:00:00

  • Wound healing and growth factor expression in T lymphocyte deficiency.

    abstract:BACKGROUND:There are many clinical situations in which immune suppression or deficiency occurs. This may lead to healing impairment. The aim of the present study was to characterize the effect of T lymphocyte deficiency on wound healing, and on -platelet-derived growth factor (PDGF), bFGF (basic fibroblast growth facto...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1046/j.1445-2197.2002.02424.x

    authors: Chircop MP,Yu Y,Berney CR,Yang JL,Crowe PJ,Walsh WR

    更新日期:2002-07-01 00:00:00

  • Treatment of scaphoid fractures using a memory alloy nail-feet-fixation device.

    abstract:BACKGROUND:Scaphoid fracture is a common carpal fracture, and its treatment often requires fixation devices. This study aimed to investigate the efficacy and safety of a memory alloy nail-feet-fixation (MANFF) device in treating scaphoid fractures. METHODS:Sixty-six patients with closed scaphoid fractures were treated...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.13641

    authors: Li C,Xu X,Su Y,Zhou T,Fan X,Xu Y

    更新日期:2016-07-01 00:00:00

  • Complete natal cleft removal with kite incision in the treatment of extensive sacrococcygeal pilonidal sinus.

    abstract:BACKGROUND:Pilonidal sinus (PS) is a benign disease for which different treatment modalities are used, varying from non-surgical treatments to surgical treatments with flap use for big defects. High recurrence is the main problem in complicated cases. We presented complete natal cleft excision with kite incision and fa...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.15550

    authors: Ozdemir H,Unal Ozdemir Z,Sunamak O

    更新日期:2020-04-01 00:00:00

  • Sentinel node biopsy and large (≥3 cm) breast cancer.

    abstract:BACKGROUND:Sentinel node biopsy is an accurate method for staging the axilla in early (small) breast cancers. However, data for the role of this technique for large breast cancers remain limited. METHOD:From the Royal Adelaide Hospital Sentinel Node database and the SNAC trial database, 100 subjects were identified wi...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/ans.12139

    authors: Beumer JD,Gill G,Campbell I,Wetzig N,Ung O,Farshid G,Uren R,Stockler M,Gebski V

    更新日期:2014-03-01 00:00:00

  • Perioperative risk analysis for acute respiratory distress syndrome after elective oesophagectomy.

    abstract:BACKGROUND:Acute respiratory distress syndrome (ARDS) is a major contributor to respiratory morbidity and mortality after oesophagectomy. Several pre-, intra- and post-operative factors are thought to predispose to its development in the post-oesophagectomy period. The aim of this study was to determine factors predisp...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章,多中心研究

    doi:10.1111/j.1445-2197.2010.05598.x

    authors: Paul DJ,Jamieson GG,Watson DI,Devitt PG,Game PA

    更新日期:2011-10-01 00:00:00

  • The learning curve in learning the curve: a review of Nuss procedure in teenagers.

    abstract:BACKGROUND:The Nuss procedure is a new minimally invasive repair for pectus excavatum that was first published in 1998. Modifications in technique are constantly evolving to minimize complications, especially bar displacement, which are higher in adolescents and adults. The present study reviews our early experience wi...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/j.1445-2197.2005.03402.x

    authors: Ong CC,Choo K,Morreau P,Auldist A

    更新日期:2005-06-01 00:00:00

  • Changing patterns of pharmacological thromboprophylaxis use by orthopaedic surgeons in New Zealand.

    abstract:BACKGROUND:A survey conducted in 1992 found that New Zealand orthopaedic surgeons relied on non-pharmacological methods of deep vein thrombosis prevention in most arthroplasty patients and almost all hip fracture patients. This survey was repeated in 1999 to ascertain whether this pattern of use had changed. METHODS:A...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1046/j.1445-2197.2002.02404.x

    authors: Walker N,Rodgers A,Gray H

    更新日期:2002-05-01 00:00:00

  • Shoulder arthroscopy heuristics.

    abstract::Technical improvements, equipment to minimize bleeding and standardizing setup positions have allowed shoulder arthroscopy to become more user friendly in diagnosis and treatment of disorders of this joint complex. ...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/j.1445-2197.2008.04758.x

    authors: Quain JS

    更新日期:2008-12-01 00:00:00

  • Reoperative adrenal surgery: lessons learnt.

    abstract::With the widespread use of abdominal imaging, the detection and therefore incidence of adrenal tumours is increasing. The laparoscopic approach to primary surgical resection of adrenal tumours has now become the standard of care. There is scarce published literature regarding the management and outcomes of recurrent a...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/j.1445-2197.2009.04892.x

    authors: Tan CT,Meyer-Rochow GY,Sywak MS,Delbridge LW,Sidhu SB

    更新日期:2009-05-01 00:00:00

  • The importance of international consensus statements in surgery.

    abstract::The article is a summary of some of the pertinent literature on professionalism, highlighting the difference between how physicians understand professionalism and how other groups e.g. politicians, nurses and hospital managers might view the professionalism of doctors. It partly explains why surgeons have become incre...

    journal_title:ANZ journal of surgery

    pub_type: 杂志文章

    doi:10.1111/j.1445-2197.2008.04822.x

    authors: Canter RJ

    更新日期:2009-03-01 00:00:00