Acute Care Surgery Models Worldwide: A Systematic Review.

Area of Science:

• Surgical Services
• Emergency Medicine
• Healthcare Management

Background:

• The Acute Care Surgery (ACS) model was established for dedicated 24/7 nontrauma emergency surgical care.
• This review examines essential ACS components and global implementation status.

Purpose of the Study:

• To identify critical components of the Acute Care Surgery (ACS) model.
• To assess the worldwide implementation of ACS models.

Main Methods:

• A systematic literature search was performed across major medical databases.
• Data on ACS models were extracted from 62 identified articles.

Main Results:

• ACS models were described in 13 countries, with variations in emergency department and operating room access.
• Most models feature dedicated nontrauma emergency surgical services with on-site attending and in-house resident coverage.
• Critical care integration varies, being embedded in the US model but often separate in other countries.

Conclusions:

• Significant international heterogeneity exists in ACS model structure and components.
• Integrating critical care is crucial for optimal patient management within the acute care chain (ACC).
• A global consensus on essential ACS components is needed to benefit healthcare systems.