Acute Care and Colorectal Surgeon Views on Management of Patients With Acute Surgical Conditions

Both acute care surgeons (ACS) and colorectal surgeons (CRS) manage patients with acute lower gastrointestinal (GI) surgical conditions. No consensus guidelines exist regarding which service is best suited to manage specific conditions. We investigated surgeon views and practice patterns regarding service allocation for the management of acute lower GI conditions.

An anonymous survey was emailed to all 237 ACS and CRS at teaching hospitals in New England with both departments (n = 19) in April 2024. Respondents rated 20 conditions on which service should manage each condition and which service usually manages the condition at their institution. Surgeons also assessed factors influencing service allocation. For each condition, the average of each service's responses was calculated and compared between the two specialties. Open-ended responses regarding barriers to creating consensus guidelines were evaluated using qualitative thematic analysis.

The response rate was 41% (n = 96), with 38% ACS (n = 55) and 45% CRS (n = 41). ACS and CRS agreed about who should manage 14 of the 20 surgical conditions. In cases of disagreement, each service preferred to manage the condition, rather than the other service. Although ACS rated CRS availability to be an important factor for decision-making, CRS felt that time of day and day of week were less important.

ACS and CRS in New England agreed on which specialty should manage several acute lower GI surgical conditions and some factors impacting these decisions. These data may be used to develop consensus guidelines to streamline care allocation and potentially limit delays in care.