ArticleWorld journal of emergency surgery : WJES2023
The new timing in acute care surgery (new TACS) classification: a WSES Delphi consensus study.
Article in World journal of emergency surgery : WJES, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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12 citing papers in PubMed.
- The real-world management of acute mesenteric ischemia in Spain: results from a multicenter national survey.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Observational
- Surveying prioritisation for emergency surgery - do the specialties involved agree?BMC surgery · 2026Article
- Article
- Surgeons' prioritization of emergency abdominal surgery and its impact on postoperative outcomes.Langenbeck's archives of surgery · 2025Article
- Balancing Ethics and Innovation: Can Artificial Intelligence Safely Transform Emergency Surgery? A Narrative Perspective.Journal of clinical medicine · 2025Article
- Emergency robotic surgery: the experience of a single center and review of the literature.World journal of emergency surgery : WJES · 2024Review
- Monitoring emergency and urgent surgery: an improvement in a Healthcare Management Unit at a third-level hospital in Italy.Journal of preventive medicine and hygiene · 2024Article
- The Operating Room management for emergency Surgical Activity (ORSA) study: a WSES international survey.Updates in surgery · 2024Article
- Resource management strategies for prioritizing non-scheduled surgical procedures in a tertiary public hospital.Clinics (Sao Paulo, Brazil) · 2024Article
- Association between timing of operative interventions and mortality in emergency general surgery.Trauma surgery & acute care open · 2024Article
- Intrainstitutional Changes of the Treatment of Supracondylar Humerus Fracture in Children over a Period of 9 Years.Children (Basel, Switzerland) · 2023Article
- Editorial: Surgical outcomes in acute care surgery: should we introduce the concept of time-critical condition?Frontiers in surgery · 2023Article
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42 authors.
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Abstract
backgroundTimely access to the operating room for emergency general surgery (EGS) indications remains a challenge across the globe, largely driven by operating room availability and staffing constraints. The "timing in acute care surgery" (TACS) classification was previously published to introduce a new tool to triage the timely and appropriate access of EGS patients to the operating room. However, the clinical and operational effectiveness of the TACS classification has not been investigated in subsequent validation studies. This study aimed to improve the TACS classification and provide further consensus around the appropriate use of the new TACS classification through a standardized Delphi approach with international experts.
methodsThis is a validation study of the new TACS by a selected international panel of experts using the Delphi method. The TACS questionnaire was designed as a web-based survey. The consensus agreement level was established to be ≥ 75%. The collective consensus agreement was defined as the sum of the percentage of the highest Likert scale levels (4-5) out of all participants. Surgical emergency diseases and correlated clinical scenarios were defined for each of the proposed classes. Subsequent rounds were carried out until a definitive level of consensus was reached. Frequencies and percentages were calculated to determine the degree of agreement for each surgical disease.
resultsFour polling rounds were carried out. The new TACS classification provides 6 colour-code classes correlated to a precise timing to surgery, defined scenarios and surgical condition. The WHITE colour-code class was introduced to rapidly (within a week) reschedule cancelled or postponed surgical procedures. Haemodynamic stability is the main tool to stratify patients for immediate surgery or not in the presence of sepsis/septic shock. Fifty-one surgical diseases were included in the different colour-code classes of priority.
conclusionThe new TACS classification is a comprehensive, simple, clear and reproducible triage system which can be used to assess the severity of the patient and the surgical disease, to reduce the time to access to the operating room, and to manage the emergency surgical patients within a "safe" timeframe. By including well-defined surgical diseases in the different colour-code classes of priority, validated through a Delphi consensus, the new TACS improves communication among surgeons, between surgeons and anaesthesiologists and decreases conflicts and waste and waiting time in accessing the operating room for emergency surgical patients.
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