Implementation of the acute care surgery model provides benefits in the surgical treatment of the acute appendicitis

Am J Surg. 2014 Nov;208(5):794-799. doi: 10.1016/j.amjsurg.2013.04.016. Epub 2014 Nov 4.


Background: Several reports have indicated the benefits of the acute care surgery (ACS) model in surgical outcomes. We tried to delineate the impact of the ACS model on surgical efficiency and quality.

Methods: Before the ACS model was implemented, abdominal surgical emergencies were evaluated by an on-call nontrauma general surgeon (pre-ACS model). An in-house trauma surgeon treated all patients with trauma or nontrauma abdominal surgical emergencies after the ACS model. Patients with acute appendicitis who underwent appendectomies were included. We conducted a pre- and poststudy to compare the time patients were in the emergency department and surgical qualities.

Results: There were 146 and 159 patients enrolled in the pre-ACS model and ACS model, respectively. The overall ED length of stay in the ACS model was significantly shorter than that in the pre-ACS model (300.3 ± 61.7 vs 719.1 ± 339.0 minutes, P < .001). Hospital LOS was also significantly shorter in the ACS model than in the pre-ACS model (2.44 ± 1.39 vs 3.83 ± 2.21 days, P = .022).

Conclusion: The ACS model may improve abdominal surgical efficiency and quality. Our study results echoed the benefits of the implementation of the ACS model shown in North America.

Keywords: Acute appendicitis; Acute care surgery; Surgical efficiency; Surgical quality.

Publication types

  • Evaluation Study

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Appendectomy*
  • Appendicitis / surgery*
  • Critical Care / methods*
  • Critical Care / organization & administration
  • Emergency Service, Hospital
  • Female
  • Humans
  • Length of Stay
  • Male
  • Middle Aged
  • Models, Theoretical
  • Quality Indicators, Health Care
  • Time Factors
  • Treatment Outcome
  • Young Adult