A special acute care surgery model for dealing with dilemmas involved in emergency department in China

There was a fast growth in the number and the formation of emergency department (ED) visits in China during the twenty-first century. As a result, engaging special medical model will be essential to decompressing the ED visits. To do this, it will be important to understand which specific aspects to focus interventions on for the greatest impact. To characterize the emergency surgery patients who were seen and discharged from ED. Retrospective cohort study of hospitalized emergency surgery patients currently under the care from specialists presenting to an urban, university affiliated hospital between 01 January 2018 and 1 January 2019. This study will highlight some of the controversies and challenges and key lessons learned. During the study period there were 231,229 ED visits; 4100 of these patients were admitted for Acute care surgery (ACS) service. Multivariate analysis identified age 65 (p=0.023; odds ratio, OR=2.66), ACS model (p=0.000, OR=0.18), ICU stay (p=0.000, OR=118.73) as factors associated with in-hospital mortality. There was a increase in length of stay between young and elderly postoperative patients when stratifying patients by age (11.67 +/- 9.48 vs 13.95 +/- 9.11 p<0.05). ED overcrowding is not just an ED problem. ED overcrowding is a systems problem requiring a systematic facility-wide multidisciplinary response. Continuous and high-quality surveillance data across China are needed to estimate the acute care surgery model which used to deal with ED overcrowding.

Automated summary

There has been a rapid increase in emergency department visits in China in the 21st century, necessitating the use of a special medical model to alleviate the burden. This study focuses on the characteristics of emergency surgery patients and factors associated with in-hospital mortality, highlighting the need for a systematic and multidisciplinary approach to address ED overcrowding.