The effect of emergency room consultations on emergency general surgery operations

BACKGROUND: Hospitalizations in emergency general surgery (EGS) cases in the USA have increased by 28% since 2001. The costs of these cases are estimated to increase by 45% annually until 2060, reaching 41.20 billion dollars. According to the literature, the general surgery clinic team allocates an average of 5.5 h a day for emergency room consultations. The aim of this study is to determine the effects of consultations from the emergency room in our country on the EGS approach and to create appropriate solution proposals with the data obtained from the regional hospitals. METHODS: The source of the data in our study is the number of EGS cases presented by 10 regional hospitals at the Central Anatolia regional meetings of The Turkish Association of Trauma and Emergency Surgery between 2017 and 2020. MATLAB R2021b (The MathWorks, Inc., Natick, Massachusetts, USA) and SPSS (IBM SPSS Statistics for Windows, version 22.0, IBM Corp., Armonk, NY, USA) programs were used for data analysis and graphics creation. RESULTS: The hospitalization/consultation rate was evaluated as the success of the doctors working at the emergency department in recognizing EGS cases; the average value was 20.15% across all hospitals. The surgery/emergency hospitalization rate, which shows rate of the hospitalized patients underwent surgery, is 59.17% when all centers are taken into account. The rate of surgery/admission in acute cholecystitis (ACC) cases is 31.49% for all centers. It is seen that the hospitalization/consultation rate decreases with the increase in hospital workload. The rate of laparoscopic/total appendectomy is 22.78% across all centers. There is a correlation between acute appendicitis cases and EGS consultation numbers, but there is no correlation between laparoscopic appendectomy and consultation numbers. In addition, it is seen that medical follow-up is preferred in ACC cases in centers where the consultation burden is increased; cholecystectomy is preferred at a higher rate in centers where the consultation burden is less. National EGS systems are needed and tried to be developed to improve the approach and outcomes of EGS patients worldwide. CONCLUSION: It is considered essential to establish a national EGS maintenance system that coordinates country resources and optimizes outcomes.