Acute Care Surgery: Trauma, Critical Care, Emergency General Surgery… Improved Compliance with Preventative Health?

Background Research productivity is critical to academic surgery and essential for advancing surgical knowledge and evidence-based practice. We aim to determine if surgeon affiliation with top US universities/hospitals (TOPS) is associated with increased research productivity measured by numbers of peer-reviewed publications in PubMed (PMIDs). Methods A bibliometric analysis was performed for PMIDs. Affiliated authors who published in trauma surgery (TS), surgical critical care (SCC), acute care surgery (ACS), and emergency general surgery (EGS) were evaluated for publications between 2015 and 2019, and lifetime productivity. Our analysis included 3443 authors from 443 different institutions. Our main outcome was PMIDs of first author (FA) and senior author (SA) in each field (2015-2019) and total lifetime publications. Results Significant differences exist between PMIDs from TOPS vs non-TOPS in FA-TS (1.34 vs 1.23, P = .001), SA-TS (1.71 vs 1.46, P < .001), total SA-PMIDs (44.10 vs 26.61, P < .001), and SA-lifetime PMIDs (90.55 vs 59.03, P < .001). There were no significant differences in PMIDs for FA or SA-SCC, FA or SA-ACS, FA or SA-EGS, FA-total PMIDs 2015-2019, or FA-lifetime PMIDs ( P > .05 for all). Conclusion There were significantly higher TS PMIDs among FAs and SAs affiliated with top US institutions in 2015-2019, along with higher total PMIDs (2015-2019) and lifetime PMIDs. These findings are of significance to future graduate medical applicants and academic surgeons who need to make decisions about training and future career opportunities.

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Acute Care Surgery: Defining Mortality in Emergency General Surgery in the State of Maryland

Journal of the American College of Surgeons ◽

10.1016/j.jamcollsurg.2014.12.051 ◽

2015 ◽

Vol 220 (4) ◽

pp. 762-770 ◽

Cited By ~ 15

Author(s):

Mayur Narayan ◽

Ronald Tesoriero ◽

Brandon R. Bruns ◽

Elena N. Klyushnenkova ◽

Hegang Chen ◽

...

Keyword(s):

Acute Care ◽

General Surgery ◽

The State ◽

Acute Care Surgery ◽

Emergency General Surgery ◽

Care Surgery

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Macroeconomic trends and practice models impacting acute care surgery

Trauma Surgery & Acute Care Open ◽

10.1136/tsaco-2018-000295 ◽

2019 ◽

Vol 4 (1) ◽

pp. e000295 ◽

Cited By ~ 5

Author(s):

Andrew Bernard ◽

Kristan Staudenmayer ◽

Joseph P Minei ◽

Jay Doucet ◽

Adil Haider ◽

...

Keyword(s):

Critical Care ◽

Acute Care ◽

Elective Surgery ◽

Care Delivery ◽

Acute Care Surgery ◽

Healthcare Organizations ◽

Emergency General Surgery ◽

Case Volume ◽

Practice Models ◽

Care Surgery

Acute care surgery (ACS) diagnoses are responsible for approximately a quarter of the costs of inpatient care in the US government, and individuals will be responsible for a larger share of the costs of this healthcare as the population ages. ACS as a specialty thus has the opportunity to meet a significant healthcare need, and by optimizing care delivery models do so in a way that improves both quality and value. ACS practice models that have maintained or added emergency general surgery (EGS) and even elective surgery have realized more operative case volume and surgeon satisfaction. However, vulnerabilities exist in the ACS model. Payer mix in a practice varies by geography and distribution of EGS, trauma, critical care, and elective surgery. Critical care codes constitute approximately 25% of all billing by acute care surgeons, so even small changes in reimbursement in critical care can have significant impact on professional revenue. Staffing an ACS practice can be challenging depending on reimbursement and due to uneven geographic distribution of available surgeons. Empowered by an understanding of economics, using team-oriented leadership inherent to trauma surgeons, and in partnership with healthcare organizations and regulatory bodies, ACS surgeons are positioned to significantly influence the future of healthcare in the USA.

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Acute care surgery and emergency general surgery

Journal of Trauma and Acute Care Surgery ◽

10.1097/ta.0000000000001016 ◽

2016 ◽

Vol 81 (1) ◽

pp. 131-136 ◽

Cited By ~ 7

Author(s):

Brandon Robert Bruns ◽

Ronald B. Tesoriero ◽

Mayur Narayan ◽

Lindsay OʼMeara ◽

Margaret H. Lauerman ◽

...

Keyword(s):

Acute Care ◽

General Surgery ◽

Acute Care Surgery ◽

Emergency General Surgery ◽

Care Surgery

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Are emergency general surgery patients more work than trauma patients? Characterizing surgeon work in an acute care surgery practice

Journal of Trauma and Acute Care Surgery ◽

10.1097/ta.0b013e318278935f ◽

2013 ◽

Vol 74 (1) ◽

pp. 289-293 ◽

Cited By ~ 5

Author(s):

Michael Bryce Parent ◽

Karina McArthur ◽

Jack Sava

Keyword(s):

Acute Care ◽

General Surgery ◽

Acute Care Surgery ◽

Trauma Patients ◽

Emergency General Surgery ◽

Care Surgery

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An Acute Care Surgery Model Provides Safe and Timely Care for Both Trauma and Emergency General Surgery Patients

Journal of Surgical Research ◽

10.1016/j.jss.2010.11.922 ◽

2011 ◽

Vol 166 (2) ◽

pp. e143-e147 ◽

Cited By ~ 20

Author(s):

Kazuhide Matsushima ◽

Alan Cook ◽

Lauren Tollack ◽

Shahid Shafi ◽

Heidi Frankel

Keyword(s):

Acute Care ◽

General Surgery ◽

Acute Care Surgery ◽

Emergency General Surgery ◽

Care Surgery

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Impact of the acute care surgery model on resident operative experience in emergency general surgery

Canadian Journal of Surgery ◽

10.1503/cjs.019619 ◽

2021 ◽

Vol 64 (3) ◽

pp. E298-E306

Author(s):

Michael T. Meschino ◽

Andrew E. Giles ◽

Paul T. Engels ◽

Timothy J. Rice ◽

Rahima Nenshi ◽

...

Keyword(s):

Acute Care ◽

General Surgery ◽

Acute Care Surgery ◽

Biliary Disease ◽

Emergency General Surgery ◽

Primary Operator ◽

After Hours ◽

Operative Experience ◽

Care Surgery ◽

Junior Residents

Background: The acute care surgery (ACS) model has been shown to improve patient, hospital and surgeon-specific outcomes. To date, however, little has been published on its impact on residency training. Our study compared the emergency general surgery (EGS) operative experiences of residents assigned to ACS versus elective surgical rotations. Methods: Resident-reported EGS case logs were prospectively collected over a 9-month period across 3 teaching hospitals. Descriptive statistics were tabulated and group comparisons were made using χ2 statistics for categorical data and t tests for continuous data. Results: Overall, 1061 cases were reported. Resident participation exceeded 90%). Appendiceal and biliary disease accounted for 49.7% of EGS cases. Residents on ACS rotations reported participating in twice as many EGS cases per block as residents on elective rotations (12.64 v. 6.30 cases, p < 0.01). Most cases occurred after hours while residents were on call rather than during daytime ACS hours (78.8% v. 21.1%, p < 0.01). Senior residents were more likely than junior residents to report having a primary operator role (71.3% v. 32.0%, p < 0.01). Although the timing of cases made no difference in the operative role of senior residents, junior residents assumed the primary operator role more often during the daytime than after hours (50.0% v. 33.1%, p = 0.01). Conclusion: Despite implementation of the ACS model, residents in our program obtained most of their EGS operative experience after hours while on call. Although further research is needed, our study suggests that improved daytime access to the operating room may represent an opportunity to improve the quantity and quality of the EGS operative experience at our academic network.

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