Patient Outcomes in Laparoscopic Appendectomy With Acute Surgical Care Model Compared to Traditional Call

Area of Science:

• Surgical Care
• Health Services Research

Background:

• Shift-based models for acute surgical care (ACS) are increasingly adopted nationwide for managing surgical emergencies.
• These models involve dedicated surgical teams working shifts without concurrent elective practices.

Purpose of the Study:

• To compare patient outcomes for appendectomy between the traditional (TRAD) call model and the ACS model.
• To evaluate the impact of the ACS model on key surgical outcomes and healthcare costs.

Main Methods:

• Retrospective review of laparoscopic appendectomy patients from 2017-2018.
• Comparison of demographics, clinical presentation, operative details, and outcomes between ACS and TRAD groups.
• Statistical analysis using independent sample t-tests, Wilcoxon rank-sum tests, and Fisher's exact or χ² tests, with regression models for confounding variables.

Main Results:

• The ACS group showed significantly reduced time from admission to operating room (-1.85 h) and length of hospital stay (-2.0 d).
• Total costs were substantially lower in the ACS group (-$2477.02).
• Perforation rates were significantly lower in the ACS group (8.3% vs. 28.6%).

Conclusions:

• Acute appendicitis management via the ACS shift-based model is associated with faster operations, shorter hospital stays, and reduced costs.
• The ACS model demonstrates equivalent success rates to the TRAD model for appendectomy, with improved safety outcomes.