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Updated: May 30, 2026

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement
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Does regionalization of acute care surgery decrease mortality?

Jose J Diaz1, Patrick R Norris, Oliver L Gunter

  • 1Division of Trauma and Surgical Critical Care, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee 37212, USA. jose.diaz@vanderbilt.edu

The Journal of Trauma
|August 10, 2011
PubMed
Summary
This summary is machine-generated.

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A mature Emergency General Surgery (EGS) service demonstrated reduced patient mortality and length of stay (LOS) over time. This improvement occurred despite consistently high severity of illness (SOI) indicators among patients, highlighting the service

Area of Science:

  • Emergency General Surgery
  • Surgical Outcomes Research
  • Healthcare Service Improvement

Background:

  • Emergency General Surgery (EGS) services often face high severity of illness (SOI) upon initial development.
  • As an EGS service matures, a decrease in patient acuity and resource utilization is anticipated.
  • This study investigates the relationship between EGS service maturity and patient outcomes.

Purpose of the Study:

  • To evaluate the impact of a matured regional Emergency General Surgery (EGS) service on patient mortality and length of stay (LOS).
  • To determine if a well-established EGS service leads to improved patient outcomes over time.
  • To analyze trends in severity of illness (SOI) markers in relation to EGS service maturity.

Main Methods:

  • Retrospective analysis of prospectively collected EGS registry data from 2004 to 2009.

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  • Patients stratified by year of discharge; high acuity defined by presence of SOI markers (e.g., sepsis, shock, perforation).
  • Nonparametric statistical tests used to compare mortality, LOS, intensive care unit admissions, SOI, charges, and distance across years.

    • Main Results:

    • A total of 3,439 patients were analyzed.
    • Severity of illness (SOI) indicators remained stable between 13% and 17% throughout the study period.
    • Mortality significantly decreased from 4.9% to 1.3% (p < 0.5) over the study years, alongside a reduction in length of stay (LOS).

    Conclusions:

    • A dedicated and mature Emergency General Surgery (EGS) service can achieve reduced mortality and length of stay (LOS).
    • These improvements are possible even with a consistently high severity of illness (SOI) among the patient population.
    • The findings support the long-term benefits of specialized EGS services.