Evidence map›Paper›PMID 32107595›Full record

ArticleWorld journal of surgery2020

The Successful Implementation of a Trauma and Acute Care Surgery Model in Ecuador.

Doris Sarmiento Altamirano, Amber Himmler, Oscar Chango Sigüenza, Raúl Pino Andrade, Nube Flores Lazo, Jeovanni Reinoso Naranjo, Hernán Sacoto Aguilar, Lenin Fernández de Córdova, Edgar Rodas, Juan Carlos Puyana and 1 more

Abstract read
PubMed Publisher
In one paragraph

Article in World journal of surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
2.4field-weighted citation impact, top 11% of its field
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

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Review
  4. Observational
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Review
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

11 authors at 6 institutions in 2 countries.

Doris Sarmiento AltamiranoFacultad de Medicina, Universidad de Azuay, Cuenca, Ecuador.
Amber HimmlerDivision of Surgery, Medstar Georgetown University Hospital and Washington Hospital Center, Washington, DC, USA. amber.n.himmler@gunet.georgetown.edu.ORCID 0000-0001-7180-5787
Oscar Chango SigüenzaDivision of Trauma and Acute Care Surgery, Hospital Vicente Corral Moscoso, Cuenca, Ecuador.
Raúl Pino AndradeDivision of Trauma and Acute Care Surgery, Hospital Vicente Corral Moscoso, Cuenca, Ecuador.
Nube Flores LazoDivision of Trauma and Acute Care Surgery, Hospital Vicente Corral Moscoso, Cuenca, Ecuador.
Jeovanni Reinoso NaranjoDivision of Trauma and Acute Care Surgery, Hospital Vicente Corral Moscoso, Cuenca, Ecuador.
Hernán Sacoto AguilarFacultad de Medicina, Universidad de Azuay, Cuenca, Ecuador.
Lenin Fernández de CórdovaDivision of Trauma and Acute Care Surgery, Hospital Vicente Corral Moscoso, Cuenca, Ecuador.
Edgar RodasDivision of Trauma and Surgery, Virginia Commonwealth University, Richmond, VA, USA.
Juan Carlos PuyanaDivision of Trauma and Surgery, University of Pittsburgh, Pittsburgh, PA, USA.
Juan Carlos Salamea MolinaFacultad de Medicina, Universidad de Azuay, Cuenca, Ecuador.
Hospital Vicente Corral Moscoso · ECUniversity of Cuenca · ECUniversity of Pittsburgh · USUniversidad Católica de Cuenca · ECUniversidad del Azuay · ECVirginia Commonwealth University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFor years, surgical emergencies in Ecuador were managed on a case-by-case basis without significant standardization. To address these issues, the Regional Hospital Vicente Corral Moscoso adapted and implemented a model of "trauma and acute care surgery" (TACS) to the reality of Cuenca, Ecuador.

methodsA cohort study was carried out, comparing patients exposed to the traditional model and patients exposed to the TACS model. Variables assessed included number of surgical patients attended to in the emergency department, number of surgical interventions, number of surgeries performed per surgeon, surgical wait time, length of stay and in-hospital mortality.

resultsThe total number of surgical interventions increased (3919.6-5745.8, p ≤ 0.05); by extension, the total number of surgeries performed per surgeon also increased (5.37-223.68, p ≤ 0.05). We observed a statistically significant decrease in surgical wait time (10.6-3.2 h for emergency general surgery, 6.3-1.6 h for trauma, p ≤ 0.05). Length of stay decreased in trauma patients (9-6 days, p ≤ 0.05). Higher mortality was found in the traditional model (p ≤ 0.05) compared to the TACS model.

conclusionsThe implementation of TACS model in a resource-restrained hospital in Latin America had a positive impact by decreasing surgical waiting time in trauma and emergency surgery patients and length of stay in trauma patients. We also noted a statistically significant decrease in mortality. Savings to the overall system and patients can be inferred by decreased mortality, length of stay and surgical wait times. To our knowledge, this is the first implementation of a TACS model described in Latin America.

Indexed as

Critical CareCohort StudiesEcuadorEmergency Service, HospitalHospital MortalityHumansLength of StayWounds and Injuries

Identifiers

PMID32107595
OpenAlexW3006953388

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.