Improved Outcomes in Treating Acute Biliary Disorders With a Shift-Based Acute Care Surgery Model

Am Surg. 2023 May;89(5):1787-1792. doi: 10.1177/00031348221074229. Epub 2022 Mar 2.

Abstract

Background: As Acute Care Surgery and shift-based models increase in popularity, there is evidence of better outcomes for many types of emergency general surgery patients. We explored the difference in outcomes for patients with acute biliary disorders, treated by either Acute Care Surgery (ACS) model or traditional call model (TRAD) during the same period.

Methods: Retrospective review of patients undergoing laparoscopic cholecystectomy for acute biliary disease 2017-2018. Demographics, clinical presentation, operative details, and outcomes were compared.

Results: Demographics, clinical presentation, and complication rates were similar between groups. Time from surgical consult to operating room (Δ = -15.34 hours [-24.57, -6.12], P = .001), length of stay (Δ = -1.4 days [-2.45, -.35], P = .009), and total charges were significantly decreased in ACS group compared to TRAD (Δ$2797.76 [-4883.12, -712.41], P = .009).

Conclusions: Acute biliary disease can be managed successfully in an ACS shift-based model with reduced overall hospital charges and equivalent outcomes.

Keywords: acute care surgery; biliary disorders; healthcare cost; laparoscopic cholecystectomy.

MeSH terms

  • Appendicitis* / surgery
  • Cholecystectomy, Laparoscopic*
  • Critical Care
  • Gallbladder Diseases* / surgery
  • Humans
  • Length of Stay
  • Retrospective Studies