ArticleCanadian journal of surgery. Journal canadien de chirurgie2014
The impact of an acute care surgery clinical care pathway for suspected appendicitis on the use of CT in the emergency department.
Article in Canadian journal of surgery. Journal canadien de chirurgie, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
5 citing papers in PubMed, 17 citations in OpenAlex.
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- Primary Care Support Tools for Digestive Health Care: A Mixed Method Study.Canadian journal of gastroenterology & hepatology · 2024Article
- A 30-day prospective audit of all inpatient complications following acute care surgery: How well do we really perform?Canadian journal of surgery. Journal canadien de chirurgie · 2020Article
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe natural evolution of an acute care surgery (ACS) service is to develop disease-specific care pathways aimed at quality improvement. Our primary goal was to evaluate the implementation of an ACS pathway dedicated to suspected appendicitis on patient flow and the use of computed tomography (CT) in the emergency department (ED).
methodsAll adults within a large health care system (3 hospitals) with suspected appendicitis were analyzed during our study period, which included 3 time periods: pre- and postimplementation of the disease-specific pathway and at 12-month follow-up.
resultsOf the 1168 consultations for appendicitis that took place during our study period, 349 occurred preimplementation, 392 occurred postimplementation, and 427 were follow-up visits. In all, 877 (75%) patients were admitted to the ACS service. Overall, 83% of patients underwent surgery within 6 hours. The mean wait time from CT request to obtaining the CT scan decreased with pathway implementation at all sites (197 v. 143 min, p < 0.001). This improvement was sustained at 12-month followup (131 min, p < 0.001). The pathway increased the number of CTs completed in under 2 hours from 3% to 42% (p < 0.001). No decrease in the total number of CTs or the pattern of ultrasonography was noted (p = 0.42). Wait times from ED triage to surgery were shortened (665 min preimplementation, 633 min postimplementation, 631 min at the 12-month follow-up, p = 0.040).
conclusionA clinical care pathway dedicated to suspected appendicitis can decrease times to both CT scan and surgical intervention.
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