Emergency general surgery outcomes at safety net hospitals

Shahan, Charles P.; Bell, Teresa M.; Paulus, Elena M.; Zarzaur, Ben L.

doi:10.1016/j.jss.2015.02.044

Cited by 50 publications

(26 citation statements)

References 7 publications

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“…On the other hand, postoperative complications are more frequent in government coverage groups compared to the uninsured group [8] . Similarly, according to Shahan and colleagues, factors such as government coverage, elderly age, black race, and males were associated with increased mortality, higher complication rates, and failure to resuscitate in emergency general surgery cases [9] . This patient fit some of these criteria.…”

Section: Discussionmentioning

confidence: 88%

Emergency total proctocolectomy in an uninsured patient with Familial Adenomatous Polyposis Syndrome and acute lower gastrointestinal hemorrhage in a community hospital: A case report

Oviedo

Dixon

Sofiak

2016

International Journal of Surgery Case Reports

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HighlightsFAP is initially managed with genetic testing, followed by yearly colonoscopy from 10 to 40 years of age.Once diagnosed, total proctocolectomy with ileal-J pouch to anal anastomosis is recommended.The ultimate treatment for FAP patients presenting with acute lower GI hemorrhage and hemodynamic compromise is unclear.This is the first literature report of an emergency total proctocolectomy for lower GI hemorrhage in an uninsured patient with FAP in a community hospital.It is essential to monitor the ileo-anal anastomosis with anoscopy.

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Section: Discussionmentioning

confidence: 88%

Emergency total proctocolectomy in an uninsured patient with Familial Adenomatous Polyposis Syndrome and acute lower gastrointestinal hemorrhage in a community hospital: A case report

Oviedo

Dixon

Sofiak

2016

International Journal of Surgery Case Reports

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“…Wakeam et al demonstrated increased failure to rescue rates following high-risk inpatient surgeries in safety-net hospitals. [21] Likewise, a study by Shahan et al found that safety-net hospitals register higher complication rates following emergency general surgery procedures[30].…”

Section: Discussionmentioning

confidence: 99%

Treatment at Safety-Net Hospitals Is Associated with Delays in Coil Embolization in Patients with Subarachnoid Hemorrhage

et al. 2018

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“…There are considerable differences among patients undergoing emergency laparotomy, not only in the indication for surgery (9,10) and the presence of co-morbidities (11), but also in factors related to the delivery of care (12). Outcomes are worse for older, frail patients (13) as well as for patients from ethnic minorities, lower socioeconomic groups and those who are uninsured (14,15). Although it is di cult to control for patient factors, evidence points to wide variability in the processes of the delivery of care (4,12,16).…”

Section: Introductionmentioning

confidence: 99%

Increasing Perioperative Risk Scoring in Emergency Laparotomy: A Surgical Trainee-Led Nationwide Quality Improvement Programme

Nally

Epo

et al. 2021

Preprint

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Background: Emergency laparotomy is associated with high morbidity and mortality. The early identification of high-risk patients allows for the provision of timely perioperative care and appropriate resource allocation. The aim of this study was to develop a nationwide surgical trainee-led quality improvement (QI) programme to increase the use of perioperative risk scoring in emergency laparotomy.Methods: The programme was structured using the active implementation framework in 15 state-funded Irish hospitals to guide the staged implementation of perioperative risk scoring. The primary outcome was a documented preoperative risk score for patients undergoing an emergency laparotomy at each site.Results: The percentage of patients undergoing emergency laparotomy who received perioperative risk scoring increased from 0-11% during the exploratory phase to 35-100% during the full implementation phase. This change was consistently maintained throughout the full implementation phase of the programme.Conclusions: A trainee-led QI programme increased the use of perioperative risk assessment in patients undergoing emergency laparotomy, suggesting that such an approach may be feasible for improving patient outcomes and care delivery performance.

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Emergency general surgery outcomes at safety net hospitals

Cited by 50 publications

References 7 publications

Emergency total proctocolectomy in an uninsured patient with Familial Adenomatous Polyposis Syndrome and acute lower gastrointestinal hemorrhage in a community hospital: A case report

Emergency total proctocolectomy in an uninsured patient with Familial Adenomatous Polyposis Syndrome and acute lower gastrointestinal hemorrhage in a community hospital: A case report

Treatment at Safety-Net Hospitals Is Associated with Delays in Coil Embolization in Patients with Subarachnoid Hemorrhage

Increasing Perioperative Risk Scoring in Emergency Laparotomy: A Surgical Trainee-Led Nationwide Quality Improvement Programme

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