Effects of delay of emergent transfer of patients requiring surgery.

“Emergency general surgery (EGS) patients require greater resources and have increased rates of morbidity and mortality. Previous work has shown mortality differences in colectomy patients between direct admissions and transfers patients based on source, including emergency department, inpatient, and nursing home transfers. We hypothesize that patient transfer status negatively effects morbidity, mortality, and resource utilization in a mixed population of EGS patients.
This study demonstrates significant increases in mortality, morbidity, and resource utilization in EGS transfer patients who were not attributable to case mix, demographics, and comorbid status alone. These data point to potential financial and quality assessment challenges for tertiary referral centers.”

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Frailty and Emergency Surgery

“Emergency surgery carries higher risk of mortality and morbidity. Appropriate risk assessment, attentive decision-making and carefully selected interventions are the cornerstones of a patient centered management.” (Leiner)

“Frailty, a “syndrome of loss of reserves,” is more than decade old concept. Initially it was used mainly in geriatrics but lately its use has been extended into other specialties including surgery. A meta-analysis demonstrated that frail surgical patients had a higher risk of readmission and increased risk of mortality.” (Leiner)

ACS NSQIP Surgical Risk Calculator

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