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Area of Science:

  • Surgical Specialties
  • Trauma Surgery
  • Surgical Critical Care

Background:

  • The definition and training for acute care surgery (ACS) remain debated.
  • A specific patient subset may require care beyond general surgical expertise, justifying a new specialty.

Purpose of the Study:

  • To identify a patient subset requiring care beyond general surgical training.
  • To differentiate acute care surgery (ACS) patients from other surgical cohorts.

Main Methods:

  • Reviewed 1-year of general surgical admissions at a Level I trauma center.
  • Classified patients into trauma, ACS, emergency general surgery (EGS), and elective surgery groups.
  • Analyzed demographics, hospital course, and outcomes, defining ACS as nonelective, nontrauma patients with significantly altered physiology.

Main Results:

  • ACS patients (4% of admissions) and trauma patients had higher rates of multiple operations, longer hospital/ICU stays, and increased mortality compared to EGS patients.
  • ACS and trauma patients were less likely to be discharged home than EGS patients.
  • EGS and elective surgery patients showed similar characteristics.

Conclusions:

  • Acute care surgery (ACS) and emergency general surgery (EGS) patients are distinct cohorts with differing critical care needs and outcomes.
  • The skills for ACS patients, including complication management and critical care, differ from EGS.
  • Findings support the development of ACS training and regionalized care.