Improved Outcomes in Treating Acute Biliary Disorders With a Shift-Based Acute Care Surgery Model

Area of Science:

• Surgical Outcomes
• Health Services Research
• Emergency Medicine

Background:

• Acute Care Surgery (ACS) and shift-based models are increasingly adopted in emergency general surgery.
• Evidence suggests improved outcomes for various emergency general surgery conditions under ACS models.
• This study compares outcomes for acute biliary disorders managed by ACS versus traditional call (TRAD) models.

Purpose of the Study:

• To compare the clinical and economic outcomes of acute biliary disorder patients treated under an ACS model versus a traditional call model.
• To evaluate the impact of different surgical care models on patient management and hospital resource utilization.

Main Methods:

• Retrospective review of patients undergoing laparoscopic cholecystectomy for acute biliary disease between 2017 and 2018.
• Comparison of demographic, clinical presentation, operative details, and patient outcomes between the ACS and TRAD groups.

Main Results:

• No significant differences were observed in demographics, clinical presentation, or complication rates between the ACS and TRAD groups.
• The ACS group demonstrated significantly shorter time from surgical consult to operating room ( -15.34 hours) and reduced length of stay ( -1.4 days).
• Total hospital charges were significantly lower in the ACS group compared to the TRAD group ( -$2797.76).

Conclusions:

• Acute biliary disease can be effectively managed within an ACS shift-based model.
• The ACS model leads to reduced hospital charges and equivalent patient outcomes compared to traditional surgical care models.
• Shift-based surgical care models offer a viable alternative for managing acute biliary disorders.