Abstract
Background
There was a fast growth in the number and the formation of ED visits in China during the twenty-first century. As a result, engaging special medical model will be essential to decompressing the ED visits. To do this, it will be important to understand which specific aspects to focus interventions on for the greatest impact.
Methods
To characterize the emergency surgery patients who were seen and discharged from ED. Retrospective cohort study of hospitalized emergency surgery patients currently under the care from specialists presenting to an urban, university affiliated hospital between 01 January 2018 and 1 January 2019. This study will highlight some of the controversies and challenges and key lessons learned.
Results
During the study period there were 231,229 ED visits; 4,100 of these patients were admitted for ACS service. Multivariate analysis identified age ≧ 65 (p = 0.023; odds ratio, OR = 2.66), ACS model (p = 0.000, OR = 0.18), ICU stay (p = 0.000, OR = 118.73) as factors associated with in-hospital mortality. There was a increase in LOS between young and elderly postoperative patients when stratifying patients by age(11.67 ± 9.48 vs 13.95 ± 9.11 p < 0.05). we first came up with this concept of Fast Track Acute Care Surgery.
Conclusions
ED overcrowding is not just an ED problem. ED overcrowding is a systems problem requiring a systematic facility-wide multidisciplinary response. Continuous and high-quality surveillance data across China are needed to estimate the emerging FTACS model which used to deal with ED overcrowding. Trial registration: retrospectively registered
Lower extremity compartment syndrome in the acute care surgery paradigm: safety lessons learned
