Evidence map›Paper›PMID 30448944›Full record

ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2020

Evolution of a Dedicated Emergency Surgery and Trauma (ESAT) unit over 3 years: sustained improved outcomes.

Si Ning Serene Goh, Woan Wui Lim, Anil Dinker Rao, Sachin Mathur, Kok Yang Tan, Tiong Thye Jerry Goo

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Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Improved outcomes for index cholecystectomy for acute cholecystitis following a dedicated emergency surgery and trauma service (ESAT).European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2021
    Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Si Ning Serene GohDepartment of General Surgery, Khoo Teck Puat Hospital, Singapore, Singapore. serene.goh@mohh.com.sg.ORCID http://orcid.org/0000-0003-4916-2142
Woan Wui LimDepartment of General Surgery, Khoo Teck Puat Hospital, Singapore, Singapore.
Anil Dinker RaoDepartment of General Surgery, Khoo Teck Puat Hospital, Singapore, Singapore.
Sachin MathurDepartment of General Surgery, Singapore General Hospital, Singapore, Singapore.
Kok Yang TanDepartment of General Surgery, Khoo Teck Puat Hospital, Singapore, Singapore.
Tiong Thye Jerry GooDepartment of General Surgery, Khoo Teck Puat Hospital, Singapore, Singapore.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe traditional 24-h call model faces pressure from competing needs between emergency and elective services. Recognizing this, a dedicated ESAT service was developed in Khoo Teck Puat Hospital in Singapore, with improved clinical outcomes. It was initially led by a single consultant (SC) in 2014, and subsequently evolved to a weekly consultant rotation (WC) roster in 2017 to achieve sustainability.

methodsEach consultant led the ESAT WC service for a week and maintained ownership of their patients thereafter. All emergency surgical admissions between two distinct 6-month periods were reviewed, from May to October 2014 (pre-ESAT) and January to June 2017 (ESAT WC). Patient demographics, diagnoses, and operations were compared. Efficiency and clinical outcomes were evaluated.

resultsThere were 1248 and 1284 patients in the pre-ESAT and ESAT WC group, respectively. Majority were males and in their 50s. Acute appendicitis, gallstone conditions, and soft-tissue infections made up half of the admissions. Trauma workload was comparable (7.8% pre-ESAT vs 9.5% ESAT WC). Cholecystectomies doubled during the ESAT period, 14.2% vs 7.2%, (p = 0.01). More consultants were involved in major cases (95.9% vs 86%), (p = 0.01) and more operations were performed during the day (52.1% vs 47.9%), (p = 0.01). Average time to OT was shorter and there were less major surgical complications (p = 0.02). Mortality (p = 0.08) and length of stay were reduced (4 vs 4.5 days), (p = 0.01).

conclusionThe ESAT WC service has sustained improved outcomes in our institution.

Indexed as

ConsultantsEfficiency, OrganizationalEmergency Service, HospitalFemaleHumansMaleMiddle AgedRetrospective StudiesSurgical Procedures, OperativeWorkflowWorkloadAcute care surgeryCost savingsEfficiency in surgeryEmergency surgeryEmergency Surgery and Trauma Surgery

Identifiers

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.