Defining a specialty through its literature: A bibliometric analysis of acute care surgery 2005 to 2020

BACKGROUND: Acute care surgery (ACS) has grown and evolved since it was conceived in 2005. However, ACS is not recognized in the National Library of Medicine's Medical Subject Heading thesaurus. This article uses bibliometrics to help define an identity for ACS as a subspecialty of surgery and argue for its addition to the Medical Subject Heading thesaurus. METHODS: The terms “Acute Care Surgery,” “Wounds and Injuries,” “General Surgery,” and “Critical Care” were searched with and without the Text Word [TW] modifier using PubMed. The intersections of search sets were identified with the AND conjunction to determine the proportion of ACS literature relevant to each subject term and calculate the penetration of ACS as a keyword term into each subject domain. RESULTS: A [Medical Subject Heading] limited search on the term “Acute Care Surgery” yielded a predictable return of 0 article. Search of the cohesive term “Acute Care Surgery” [All Fields], restricted to MEDLINE-indexed, English-language articles yielded 2,351 articles published between 2005 and 2020, inclusive. Using ACS as [Text Word] yielded 517 articles. There was a progressive increase in the rate of annual publications. The frequency of subject terms in the ACS [All Fields] set was as follows: Critical Care, 49.70%; General Surgery, 23.26%; and Wounds and Injuries, 20.88%. The frequency of subject terms in the ACS [TW] set was as follows: Critical Care, 32.88%; General Surgery, 43.52%; and Wounds and Injuries, 15.28%. Of this set, 8.32% of articles were not tagged or did not contain a reference to any of these 3 major subjects. CONCLUSION: This study demonstrates that ACS as a subject matter is being increasingly expressed in the literature. Adding ACS as a dedicated term into the National Library of Medicine's Medical Subject Heading thesaurus of controlled vocabulary as a specialty of Surgery would facilitate indexing and retrieval of the literature most relevant to acute care surgeons.