Sabrina Cheok Hx, Dr, Serene Goh Sn, Woan Wui Lim, Anil Rao Dinkar, Kok Yang Tan, Jerry Goo Tt. Department of General Surgery, Khoo Teck Puat Hospital
Introduction: The Emergency Surgery and Trauma (ESAT) is a consultant led service to streamline emergency and elective workloads. As appendicectomy is one of the commonest emergency surgeries performed, we aim to compare outcomes of patients with appendicitis in the ESAT model as compared to the traditional on-call model.
Methods: We conducted a retrospective review of patients admitted to KTPH between two 6-month time periods: May – October 2014 (6 months pre-ESAT) vs January – June 2018 (post-ESAT) Patient demographics, diagnoses, and operations were compared. Efficiency, clinical outcomes and hospital bill savings were evaluated.
Results: There were 179 patients in the pre-ESAT period and 167 patients in the post-ESAT period. Patient demographics and comorbidities were comparable: mean age was 38.6 ? 15.8, majority were males (63.9%) and mean Charlson’s comorbidity index was 0.08. In the post-ESAT period patients had longer duration of symptoms 2.0 ? 1.8 days vs 1.8 ? 1.6 days (p=0.08). There were more perforated appendixes in the post-ESAT period 25.8% vs pre-ESAT period 20.1% (p=0.221). Majority underwent laparoscopic appendicectomy 85% (pre-ESAT) vs 89.3%. More patients in pre-ESAT period had conversion to open or open appendicectomy (p = 0.05). The remainder had antibiotics or percutaneous drainage for appendiceal abscesses. There were lower surgical complications 7.8% vs 9.5% in post-ESAT period (p=0.02), shorter length of stay 2.5 ?2.0 days vs 2.7 ? 2.9 (p=0.07) and higher supervision rates during surgery in the post-ESAT period(p=0.01). The hospital bill sizes were comparable (p=0.475).
Conclusion: The ESAT service has improved outcomes of patients with appendicitis without increased costs.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 93842
Program Number: P016
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster