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Impact of surgical specialization on emergency upper gastrointestinal surgery outcomes: A systematic review and meta-analysis.
Barbaro, Antonio; Bunjo, Zachary; Asokan, Gayatri; Kanhere, Akshay; Kuan, Li Lian; Trochsler, Markus; Kanhere, Harsh; Maddern, Guy J.
Afiliación
  • Barbaro A; The University of Adelaide, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia.
  • Bunjo Z; The University of Adelaide, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia.
  • Asokan G; The University of Adelaide, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia.
  • Kanhere A; The University of Adelaide, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia.
  • Kuan LL; The University of Adelaide, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia.
  • Trochsler M; The University of Adelaide, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia.
  • Kanhere H; Division of Upper Gastrointestinal Surgery, The Royal Adelaide Hospital, Adelaide, South Australia, Australia.
  • Maddern GJ; The University of Adelaide, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia.
World J Surg ; 48(8): 1941-1949, 2024 Aug.
Article en En | MEDLINE | ID: mdl-38956401
ABSTRACT

BACKGROUND:

Emergency presentations make up a large proportion of a general surgeon's workload. Patients who have emergency surgery carry a higher rate of mortality and complications. We aim to review the impact of surgical subspecialization on patients following upper gastrointestinal (UGI) emergency surgery.

METHODS:

A systematic search of Ovid Embase, Ovid MEDLINE, and Cochrane databases using a predefined search strategy was completed reviewing studies published from 1st of January 1990 to August 27, 2023. The study was prospectively registered with PROSPERO (CRD42022359326). Studies were reviewed for the following

outcomes:

30-day mortality, in-hospital mortality, conversion to open, length of stay, return to theater, and readmission.

RESULTS:

Of 5181 studies, 24 articles were selected for full text review. Of these, seven were eligible and included in this study. There was a statistically significant improvement in 30-day mortality favoring UGI specialists (OR 0.71 [95% CI 0.55-0.92 and p = 0.009]) and in-hospital mortality (OR 0.29 [95% CI 0.14-0.60 and p = 0009]). There was a high degree of study heterogeneity in 30-day mortality; however, a low degree of heterogeneity within in-hospital mortality. There was no statistical significance when considering conversion to open and insufficient data to allow meta-analysis for return to theater or readmission rates.

CONCLUSION:

In emergency UGI surgery, there was improved 30-day and in-hospital mortality for UGI specialists. Therefore, surgeons should consider early involvement of a subspecialist team to improve patient outcomes.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Procedimientos Quirúrgicos del Sistema Digestivo / Mortalidad Hospitalaria Límite: Humans Idioma: En Revista: World J Surg Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Procedimientos Quirúrgicos del Sistema Digestivo / Mortalidad Hospitalaria Límite: Humans Idioma: En Revista: World J Surg Año: 2024 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Estados Unidos