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Emergency general surgery and the implications for specialisation.

E J Dawson1, S Paterson-Brown

  • 1Department of Surgery, Royal Infirmary, Little France, Edinburgh, EH16 4SA, UK.

The Surgeon : Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
|December 2, 2004
PubMed
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Emergency general surgery admissions in Edinburgh show head injuries and abdominal pain are common. An Accident and Emergency (A&E) department influences patient diagnoses and surgical workload, with increasing sub-specialisation observed.

Area of Science:

  • General Surgery
  • Surgical Audit
  • Healthcare Planning

Background:

  • Examining emergency general surgical admissions and operations in Edinburgh.
  • Assessing the impact of an Accident and Emergency (A&E) department.
  • Observing current sub-specialisation practices in emergency surgery.

Purpose of the Study:

  • To analyze the full range of emergency general surgical admissions and procedures in Edinburgh.
  • To determine how an A&E department influences surgical case mix and workload.
  • To evaluate the extent of sub-specialisation among emergency surgeons.

Main Methods:

  • Prospective data collection on all general surgical admissions and operations in two Edinburgh hospitals.
  • Utilisation of the Lothian Surgical Audit system for data recording.

Related Experiment Videos

  • Analysis of data specifically for the year 1999.

    • Main Results:

    • 5346 patients admitted with acute surgical conditions; head injuries and non-specific abdominal pain comprised one-third of admissions.
    • Appendectomy was the most frequent operation. The hospital with an A&E department had higher admissions but a lower operative rate.
    • Evidence of advanced sub-specialisation was noted, with specific surgical teams managing distinct patient groups.

    Conclusions:

    • The pattern of emergency surgery aligns with existing literature.
    • The presence of an A&E department significantly impacts diagnostic spectrum and overall surgical workload.
    • Advanced sub-specialisation in emergency surgery has implications for future healthcare planning and resource allocation.