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Anheuser P, Michels G, Gakis G, Neisius A, Steffens J, Kranz J. [Position paper of the working group Urological Acute Medicine]. UROLOGIE (HEIDELBERG, GERMANY) 2023; 62:936-940. [PMID: 37115300 DOI: 10.1007/s00120-023-02090-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/23/2023] [Indexed: 04/29/2023]
Abstract
Emergency patients with acute genitourinary system diseases are frequently encountered in both outpatient and clinical emergency structures. It is estimated that one-third of all inpatients in a urology clinic initially present as an emergency. In addition to general emergency medicine knowledge, specialized urologic expertise is a prerequisite for the care of these patients, which is needed early and specifically for optimal treatment outcomes. It must be taken into account that, on the one hand, the current structures of emergency care still lead to delays in patient care despite positive developments in recent years. On the other hand, most hospital emergency facilities need urologic expertise on site. In addition, politically intended changes in our health care system, which drive an increasing ambulantization of medicine and condition a further centralization of emergency clinics, become effective. The aim of the newly established working group "Urological Acute Medicine" is to ensure and further improve the quality of care for emergency patients with acute genitourinary system diseases and, in consensus with the German Society of Interdisciplinary Emergency and Acute Medicine, to define precise task distributions and interfaces of both specialities.
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Affiliation(s)
- Petra Anheuser
- Klinik für Urologie, Asklepios Klinik Wandsbek, Alphonsstr. 14, 22403, Hamburg, Deutschland.
- Universitätsklinik und Poliklinik für Urologie, Universitätsklinikum Halle (Saale), Halle (Saale), Deutschland.
| | - Guido Michels
- Klinik für Akut- und Notfallmedizin, St. Antonius-Hospital gGmbH, Eschweiler, Deutschland
| | - Georgios Gakis
- Universitätsklinik und Poliklinik für Urologie, Universitätsklinikum Halle (Saale), Halle (Saale), Deutschland
| | - Andreas Neisius
- Abteilung für Urologie und Kinderurologie, Krankenhaus der Barmherzigen Brüder Trier, Medizincampus der Universitätsmedizin Mainz, Trier, Deutschland
| | - Joachim Steffens
- Klinik für Urologie und Kinderurologie, St. Antonius-Hospital gGmbH, Eschweiler, Deutschland
| | - Jennifer Kranz
- Universitätsklinik und Poliklinik für Urologie, Universitätsklinikum Halle (Saale), Halle (Saale), Deutschland
- Klinik für Urologie und Kinderurologie, Uniklinik RWTH Aachen, Aachen, Deutschland
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Wangen E, Gillund EW, Reinholdtsen EM, Henriksveen KJ, van Duinen AJ, Faqiri M, Ystgaard B, Bolkan HA. Emergency laparotomy at St Olav's Hospital, Trondheim. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2023; 143:21-0797. [PMID: 37097250 DOI: 10.4045/tidsskr.21.0797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Emergency laparotomies are associated with higher mortality and longer hospital stays than elective laparotomies. The purpose of this study was to survey patient characteristics, hospital care pathways, and mortality for patients undergoing emergency laparotomy at St Olav's Hospital, Trondheim. MATERIAL AND METHODS This is a retrospective cohort study of all patients over 18 years of age who underwent emergency laparotomy at St Olav's Hospital, Trondheim, between 1 January 2015 and 1 April 2020. Patients were selected based on National Emergency Laparotomy Audit inclusion and exclusion criteria. Surgeries due to trauma or appendicitis were excluded, as were those for gynaecological or vascular aetiology. Patient and surgery characteristics, as well as date of death, were retrieved from electronic medical records. RESULTS A total of 939 patients with a median (interquartile range) age of 68 years (54-76) were included. Intestinal obstruction was the primary indication for surgery in 488 (52.0 %) patients, followed by perforation in 220 (23.4 %) and ischaemia in 85 (9.1 %). In all, 788 (83.9 %) patients underwent emergency surgery within the timeframe scheduled. The median postoperative hospital stay was 10 days (6-18) and 30-day mortality was 8.2 %. INTERPRETATION Although caution should be exercised when comparing findings between studies, our results suggest that the quality of treatment at St Olav's Hospital, Trondheim, is on a par with that at similar institutions. At the same time, the study provides an opportunity to identify areas for improvement in the provision of emergency surgery.
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Kinnear N, Jolly S, Herath M, Han J, Tran M, O'Callaghan M, Hennessey D, Dobbins C, Sammour T, Moore J. The acute surgical unit: An updated systematic review and meta-analysis. Int J Surg 2021; 94:106109. [PMID: 34536599 DOI: 10.1016/j.ijsu.2021.106109] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 08/07/2021] [Accepted: 09/07/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To systematically review comparative studies on the acute surgical unit (ASU) model. METHODS Searches were performed of Cochrane, Embase, Medline and grey literature. Eligible articles were comparative studies of the Acute Surgical Unit (ASU) model published 01/01/2000-12/03/2020. Amongst patients with any diagnosis, primary outcomes were length of stay, after-hours operating, complications and cost. Secondary outcomes were time to surgical review, time to theatre, mortality and re-admission for patients with any diagnosis, and cholecystectomy during index admission for patients with biliary disease. Additional analyses were planned for specific cohorts, such as patients with appendicitis or cholecystitis. RESULTS Searches returned 9,677 results from which 77 eligible publications were identified, representing 150,981 unique patients. Cohorts were adequately homogenous for meta-analysis of all outcomes except cost. For patients with any diagnosis, compared with the Traditional model, the introduction of an ASU model was associated with reduced length of stay (mean difference [MD] 0.68 days; 95% confidence interval [CI] 0.38-0.98), after-hours operating rates (odds ratio [OR] 0.56; 95% CI 0.46-0.69) and complications (OR 0.48, 95% CI 0.33-0.70). Regarding cost, two studies reported savings following ASU introduction, while one found no difference. Amongst secondary outcomes, for patients with any diagnosis, ASU commencement was associated with reduced time to surgical review, time to theatre and mortality. Re-admissions were unchanged. For patients with biliary disease, ASU establishment was associated with superior rates of index cholecystectomy. CONCLUSION Compared to the Traditional structure, the ASU model is superior for most metrics. ASU introduction should be promoted in policy for widespread benefit.
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Affiliation(s)
- Ned Kinnear
- Adelaide Medical School, University of Adelaide, Adelaide, Australia Dept of Surgery, Royal Adelaide, Hospital, Adelaide, Australia Urology Unit, Flinders Medical Centre, Bedford Park, SA, Australia Flinders University, Adelaide, Australia Dept of Urology, Mercy University Hospital, Cork, Ireland
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Kinnear N, Herath M, Jolly S, Han J, Tran M, Parker D, O'Callaghan M, Hennessey D, Dobbins C, Sammour T, Moore J. Patient Satisfaction in Emergency General Surgery: A Prospective Cross-Sectional Study. World J Surg 2021; 44:2950-2958. [PMID: 32399656 DOI: 10.1007/s00268-020-05561-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND The importance of the patient experience is increasingly being recognised. However, there is a dearth of studies regarding factors affecting patient-reported outcomes in emergency general surgery (EGS), including none from the Southern Hemisphere. We aim to prospectively assess factors associated with patient satisfaction in this setting. METHODS In this prospective cross-sectional study, all consecutive adult patients admitted to an acute surgical unit over four weeks were invited to complete a validated Patient-Reported Experience Measures questionnaire. These were completed either in person when discharge was imminent or by telephone <4 weeks post-discharge. Responses were used to determine factors associated with overall patient satisfaction. RESULTS From 146 eligible patients, 100 (68%) completed the questionnaire, with a mean overall satisfaction score of 8.3/10. On multivariate analyses, eight factors were significantly associated with increased overall satisfaction. Five of these were similar to those previously prescribed by other like studies, being patient age >50 years, sufficient analgesia, satisfaction with the level of senior medical staff, important questions answered by nurses and confidence in decisions made about treatment. Three identified factors were new: sufficient privacy in the emergency department, sufficient notice prior to discharge and feeling well looked after in hospital. CONCLUSIONS Factors associated with patient satisfaction were identified at multiple points of the patient journey. While some of these have been reported in similar studies, most differed. Hospitals should assess factors valued by their EGS population prior to implementing initiatives to improve patient satisfaction.
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Affiliation(s)
- Ned Kinnear
- Adelaide Medical School, University of Adelaide, Adelaide, SA, 5000, Australia.
| | - Matheesha Herath
- Department of Surgery, Royal Adelaide Hospital, Adelaide, Australia
| | - Samantha Jolly
- Department of Surgery, Royal Adelaide Hospital, Adelaide, Australia
| | - Jennie Han
- Department of Surgery, Royal Adelaide Hospital, Adelaide, Australia
| | - Minh Tran
- Department of Surgery, Royal Adelaide Hospital, Adelaide, Australia
| | - Dominic Parker
- Department of Surgery, Royal Adelaide Hospital, Adelaide, Australia
| | - Michael O'Callaghan
- Adelaide Medical School, University of Adelaide, Adelaide, SA, 5000, Australia.,South Australian Prostate Cancer Clinical Outcomes Collaborative, Urology Unit, Flinders Medical Centre, Adelaide, Australia.,Flinders Centre for Innovation in Cancer, Adelaide, Australia
| | - Derek Hennessey
- Department of Urology, Mercy University Hospital, Cork, Ireland
| | | | - Tarik Sammour
- Adelaide Medical School, University of Adelaide, Adelaide, SA, 5000, Australia.,Department of Surgery, Royal Adelaide Hospital, Adelaide, Australia
| | - James Moore
- Adelaide Medical School, University of Adelaide, Adelaide, SA, 5000, Australia.,Department of Surgery, Royal Adelaide Hospital, Adelaide, Australia
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van der Wee MJL, van der Wilden G, Hoencamp R. Acute Care Surgery Models Worldwide: A Systematic Review. World J Surg 2021; 44:2622-2637. [PMID: 32377860 PMCID: PMC7326827 DOI: 10.1007/s00268-020-05536-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background The Acute Care Surgery (ACS) model was developed as a dedicated service for the provision of 24/7 nontrauma emergency surgical care. This systematic review investigated which components are essential in an ACS model and the state of implementation of ACS models worldwide. Methods A literature search was conducted using PubMed, MEDLINE, EMBASE, Cochrane library, and Web of Science databases. All relevant data of ACS models were extracted from included articles. Results The search identified 62 articles describing ACS models in 13 countries. The majority consist of a dedicated nontrauma emergency surgical service, with daytime on-site attending coverage (cleared from elective duties), and 24/7 in-house resident coverage. Emergency department coverage and operating room access varied widely. Critical care is fully embedded in the original US model as part of the acute care chain (ACC), but is still a separate unit in most other countries. While in most European countries, ACS is not a recognized specialty yet, there is a tendency toward more structured acute care. Conclusions Large national and international heterogeneity exists in the structure and components of the ACS model. Critical care is still a separate component in most systems, although it is an essential part of the ACC to provide the best pre-, intra- and postoperative care of the physiologically deranged patient. Universal acceptance of one global ACS model seems challenging; however, a global consensus on essential components would benefit any healthcare system.
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Affiliation(s)
- Mats J L van der Wee
- Alrijne Hospital, Leiderdorp, The Netherlands. .,Leiden University Medical Center, Leiden, The Netherlands.
| | - Gwendolyn van der Wilden
- Alrijne Hospital, Leiderdorp, The Netherlands.,Leiden University Medical Center, Leiden, The Netherlands
| | - Rigo Hoencamp
- Alrijne Hospital, Leiderdorp, The Netherlands.,Leiden University Medical Center, Leiden, The Netherlands.,Defense Healthcare Organization, Ministry of Defense, Utrecht, The Netherlands.,Erasmus University Medical Center, Rotterdam, The Netherlands
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A systematic review of dedicated models of care for emergency urological patients. Asian J Urol 2020; 8:315-323. [PMID: 34401338 PMCID: PMC8356060 DOI: 10.1016/j.ajur.2020.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 01/20/2020] [Accepted: 04/21/2020] [Indexed: 11/09/2022] Open
Abstract
Objective To systematically evaluate the spectrum of models providing dedicated resources for emergency urological patients (EUPs). Methods A search of Cochrane, Embase, Medline and grey literature from January 1, 2000 to March 26, 2019 was performed using methods pre-published on PROSPERO. Reporting followed Preferred Reporting Items for Systematic Review and meta-analysis guidelines. Eligible studies were articles or abstracts published in English describing dedicated models of care for EUPs, which reported at least one secondary outcome. Studies were excluded if they examined pathways dedicated only to single presentations, such as torsion, or outpatient solutions, such as rapid access clinics. The primary outcome was the spectrum of models. Secondary outcomes were time-to-theatre, length of stay, complications and cost. Results Seven studies were identified, totalling 487 patients. Six studies were conference abstracts, while one study was of full-text length but published in grey literature. Four distinct models were described. These included consultant urologists allocated solely to the care of EUPs (“Acute Urological Unit”) or dedicated registrars or operating theatres (“Hybrid structures”). In some services, EUPs bypassed emergency department assessment and were referred directly to urology (“Urological Assessment Unit”) or were managed by other dedicated means. Allocating services to EUPs was associated with reduced time-to-theatre, length of stay and hospital cost, and improved supervision of junior medical staff. Conclusion Multiple dedicated models of care exist for EUPs. Low-level evidence suggests these may improve outcomes for patients, staff and hospitals. Higher quality studies are required to explore patient outcomes and minimum requirements to establish these models.
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Kinnear N, Tran M, Han J, Jolly S, Herath M, Hennessey D, Dobbins C, Sammour T, Moore J. Does emergency general surgery model affect staff satisfaction, training and working hours? ANZ J Surg 2019; 90:262-267. [DOI: 10.1111/ans.15628] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 11/15/2019] [Accepted: 11/16/2019] [Indexed: 01/11/2023]
Affiliation(s)
- Ned Kinnear
- Discipline of Surgery, Faculty of Medical and Health Sciences, Adelaide Medical SchoolThe University of Adelaide Adelaide South Australia Australia
- Department of SurgeryRoyal Adelaide Hospital Adelaide South Australia Australia
| | - Minh Tran
- Department of SurgeryRoyal Adelaide Hospital Adelaide South Australia Australia
| | - Jennie Han
- Department of SurgeryRoyal Adelaide Hospital Adelaide South Australia Australia
| | - Samantha Jolly
- Department of SurgeryRoyal Adelaide Hospital Adelaide South Australia Australia
| | - Matheesha Herath
- Department of SurgeryRoyal Adelaide Hospital Adelaide South Australia Australia
| | | | - Christopher Dobbins
- Discipline of Surgery, Faculty of Medical and Health Sciences, Adelaide Medical SchoolThe University of Adelaide Adelaide South Australia Australia
| | - Tarik Sammour
- Discipline of Surgery, Faculty of Medical and Health Sciences, Adelaide Medical SchoolThe University of Adelaide Adelaide South Australia Australia
- Department of SurgeryRoyal Adelaide Hospital Adelaide South Australia Australia
| | - James Moore
- Discipline of Surgery, Faculty of Medical and Health Sciences, Adelaide Medical SchoolThe University of Adelaide Adelaide South Australia Australia
- Department of SurgeryRoyal Adelaide Hospital Adelaide South Australia Australia
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Kinnear N, Heijkoop B, Bramwell E, Frazzetto A, Noll A, Patel P, Hennessey D, Otto G, Dobbins C, Sammour T, Moore J. Communication and management of incidental pathology in 1,214 consecutive appendicectomies; a cohort study. Int J Surg 2019; 72:185-191. [PMID: 31683040 DOI: 10.1016/j.ijsu.2019.10.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 10/08/2019] [Accepted: 10/23/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND Important incidental pathology requiring further action is commonly found during appendicectomy, macro- and microscopically. We aimed to determine whether the acute surgical unit (ASU) model improved the management and disclosure of these findings. METHODS An ASU model was introduced at our institution on 01/08/2012. In this retrospective cohort study, all patients undergoing appendicectomy 2.5 years before (Traditional group) or after (ASU group) this date were compared. The primary outcomes were rates of appropriate management of the incidental findings, and communication of the findings to the patient and to their general practitioner (GP). RESULTS 1,214 patients underwent emergency appendicectomy; 465 in the Traditional group and 749 in the ASU group. 80 (6.6%) patients (25 and 55 in each respective period) had important incidental findings. There were 24 patients with benign polyps, 15 with neuro-endocrine tumour, 11 with endometriosis, 8 with pelvic inflammatory disease, 8 Enterobius vermicularis infection, 7 with low grade mucinous cystadenoma, 3 with inflammatory bowel disease, 2 with diverticulitis, 2 with tubo-ovarian mass, 1 with secondary appendiceal malignancy and none with primary appendiceal adenocarcinoma. One patient had dual pathologies. There was no difference between the Traditional and ASU group with regards to communication of the findings to the patient (p = 0.44) and their GP (p = 0.27), and there was no difference in the rates of appropriate management (p = 0.21). CONCLUSION The introduction of an ASU model did not change rates of surgeon-to-patient and surgeon-to-GP communication nor affect rates of appropriate management of important incidental pathology during appendectomy.
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Affiliation(s)
- Ned Kinnear
- Dept of Surgery, Lyell McEwin Hospital, Adelaide, Australia; Dept of Surgery, Port Augusta Hospital, Port Augusta, Australia; Adelaide Medical School, University of Adelaide, Adelaide, Australia.
| | | | - Eliza Bramwell
- Dept of Surgery, Port Augusta Hospital, Port Augusta, Australia
| | - Alannah Frazzetto
- Dept of Surgery, Port Augusta Hospital, Port Augusta, Australia; Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Amy Noll
- Dept of Surgery, Port Augusta Hospital, Port Augusta, Australia; Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Prajay Patel
- Dept of Surgery, Port Augusta Hospital, Port Augusta, Australia; Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | | | - Greg Otto
- Dept of Surgery, Lyell McEwin Hospital, Adelaide, Australia
| | | | - Tarik Sammour
- Dept of Surgery, Royal Adelaide, Hospital, Adelaide, Australia; Dept of Surgery, Faculty of Medical and Health Sciences, University of Adelaide, Adelaide, Australia
| | - James Moore
- Dept of Surgery, Royal Adelaide, Hospital, Adelaide, Australia; Dept of Surgery, Faculty of Medical and Health Sciences, University of Adelaide, Adelaide, Australia
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Barnett DR, Lu H, Finlay B, Coventry C, Granchi N, Marshall-Webb M, Heitmann P, Dobbins C. Lessons learned from relocating an acute surgical unit to a new quaternary referral centre in Adelaide, South Australia: a tale of two hospitals. ANZ J Surg 2019; 89:1620-1625. [PMID: 31637831 DOI: 10.1111/ans.15498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 08/28/2019] [Accepted: 08/31/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND On 4 September 2017, patient care was relocated from one quaternary hospital that was closing, to another proximate greenfield site in Adelaide, Australia, this becoming the new Royal Adelaide Hospital. There are currently no data to inform how best to transition hospitals. We conducted a 12-week prospective study of admissions under our acute surgical unit to determine the impact on our key performance indicators. We detail our results and describe compensatory measures deployed around the move. METHODS Using a standard proforma, data were collected on key performance indicators for acute surgical unit patients referred by the emergency department (ED). This was supplemented by data obtained from operative management software and coding data from medical records to build a database for analysis. RESULTS Five hundred and eight patients were admitted during the study period. Significant delays were seen in times to surgical referral, surgical review and leaving the ED. Closely comparable was time spent in the surgical suite. Uptake of the Ambulatory Care Pathway fell by 67% and the Rapid Access Clinic by 46%. Overall mortality and patient length of stay were not affected. CONCLUSION We found the interface with ED was most affected. Staff encountered difficulties familiarizing with a new environment and an anecdotally high number of ED presentations. Delays to referral and surgical review resulted in extended patient stay in ED. Once in theatre, care was comparable pre- and post-transition. This was likely from early identification of patients requiring an emergency operation, close consultant surgeon involvement and robust working relationships between surgeons, anaesthetists and nurses.
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Affiliation(s)
- Dylan R Barnett
- Faculty of Health Sciences, The University of Adelaide, Adelaide, South Australia, Australia.,Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Ha Lu
- Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Ben Finlay
- Faculty of Health Sciences, The University of Adelaide, Adelaide, South Australia, Australia.,Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Charlie Coventry
- Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Nelson Granchi
- Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Matthew Marshall-Webb
- Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Paul Heitmann
- Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Christopher Dobbins
- Faculty of Health Sciences, The University of Adelaide, Adelaide, South Australia, Australia.,Department of Surgery, Royal Adelaide Hospital, Adelaide, South Australia, Australia
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Kinnear N, Bramwell E, Frazzetto A, Noll A, Patel P, Hennessey D, Otto G, Dobbins C, Sammour T, Moore J. Acute surgical unit improves outcomes in appendicectomy. ANZ J Surg 2019; 89:1108-1113. [PMID: 30989789 DOI: 10.1111/ans.15141] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 01/28/2019] [Accepted: 02/11/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Ned Kinnear
- Department of SurgeryLyell McEwin Hospital Adelaide South Australia Australia
- Department of SurgeryPort Augusta Hospital Port Augusta South Australia Australia
| | - Eliza Bramwell
- Department of SurgeryPort Augusta Hospital Port Augusta South Australia Australia
| | - Alannah Frazzetto
- Department of SurgeryPort Augusta Hospital Port Augusta South Australia Australia
- Adelaide Medical SchoolThe University of Adelaide Adelaide South Australia Australia
| | - Amy Noll
- Department of SurgeryPort Augusta Hospital Port Augusta South Australia Australia
- Adelaide Medical SchoolThe University of Adelaide Adelaide South Australia Australia
| | - Prajay Patel
- Department of SurgeryPort Augusta Hospital Port Augusta South Australia Australia
- Adelaide Medical SchoolThe University of Adelaide Adelaide South Australia Australia
| | | | - Greg Otto
- Department of SurgeryLyell McEwin Hospital Adelaide South Australia Australia
| | - Christopher Dobbins
- Department of SurgeryRoyal Adelaide Hospital Adelaide South Australia Australia
| | - Tarik Sammour
- Adelaide Medical SchoolThe University of Adelaide Adelaide South Australia Australia
- Department of SurgeryRoyal Adelaide Hospital Adelaide South Australia Australia
| | - James Moore
- Adelaide Medical SchoolThe University of Adelaide Adelaide South Australia Australia
- Department of SurgeryRoyal Adelaide Hospital Adelaide South Australia Australia
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Bazzi ZT, Kinnear N, Bazzi CS, Hennessey D, Henneberg M, Otto G. Impact of an acute surgical unit on outcomes in acute cholecystitis. ANZ J Surg 2018; 88:E835-E839. [DOI: 10.1111/ans.14802] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 07/04/2018] [Accepted: 07/05/2018] [Indexed: 12/20/2022]
Affiliation(s)
- Zacharia T. Bazzi
- Department of Surgery; Lyell McEwin Hospital; Adelaide South Australia Australia
| | - Ned Kinnear
- Department of Surgery; Lyell McEwin Hospital; Adelaide South Australia Australia
- Department of Urology; Austin Health; Melbourne Victoria Australia
| | - Ciara S. Bazzi
- Department of Surgery; Modbury Hospital; Adelaide South Australia Australia
| | - Derek Hennessey
- Department of Urology; Austin Health; Melbourne Victoria Australia
| | - Maciej Henneberg
- Department of Medical Sciences; The University of Adelaide; Adelaide South Australia Australia
| | - Greg Otto
- Department of Surgery; Lyell McEwin Hospital; Adelaide South Australia Australia
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