Panamerican Journal of Trauma, Critical Care & Emergency Surgery

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VOLUME 10 , ISSUE 1 ( January-April, 2021 ) > List of Articles

Original Article

Surgical Rescue in a High-volume Urban Emergency General Surgery Service at a Middle-income Country

Maria F Jimenez, Andrés Isaza-Restrepo, Danny Conde, Alex Arroyo, Milcíades Ibánez-Pinilla, Felipe Borda, Daniel Colmenares, Juan C Puyana

Keywords : Electronic registry, General emergency surgery, Surgical rescue

Citation Information : Jimenez MF, Isaza-Restrepo A, Conde D, Arroyo A, Ibánez-Pinilla M, Borda F, Colmenares D, Puyana JC. Surgical Rescue in a High-volume Urban Emergency General Surgery Service at a Middle-income Country. Panam J Trauma Crit Care Emerg Surg 2021; 10 (1):16-19.

DOI: 10.5005/jp-journals-10030-1305

License: CC BY-NC 4.0

Published Online: 00-04-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Introduction: The capacity for prompt “rescue” from death in patients with complications has become an important marker of the quality of care since mortality and morbidity have been identified as incongruous indicators. This study aims to describe the incidence of “surgical rescue” failure and the outcomes of emergency general surgery (EGS) patients at a large academic medical center. Materials and methods: In our high-volume surgical hospital, an electronic EGS registry was developed to automatically capture in-hospital information and outcomes from the Electronic Medical Record (EMR). Surgical complications were included in an online application and automatically captured in the electronic EGS registry, and prospectively screened from June to July 2017 for acute EGS surgical patients from operative procedures. Results: A total of 501 patients (average age: 53.9 ± 20.9, 56.5% female) underwent 882 EGS procedures. Thirteen patients (2.6%) of the 501 patients required “surgical rescue”, mainly for uncontrolled sepsis (43%) and anastomotic leakage (30%). The surgical rescue failure rate (inability to prevent death after a surgical complication) was 15.4%. Patients requiring critical care (OR = 3.3, IC 95%: 1.04, 10.5), hospital admission (p = 0.038), and hospital LOS (days) (p = 0.004) were significantly higher for the surgical rescue patients than for those without complications. Conclusion: Surgical failure to rescue rate was similar among high-volume EGS services, as has recently been described in the United States. The latest development and implementation of an electronic automatic captured EGS registry database in our academic medical center will serve to build best practices for “surgical rescue” and drive quality improvement programs.


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