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The Successful Implementation of a Trauma and Acute Care Surgery Model in Ecuador.
Sarmiento Altamirano, Doris; Himmler, Amber; Chango Sigüenza, Oscar; Pino Andrade, Raúl; Flores Lazo, Nube; Reinoso Naranjo, Jeovanni; Sacoto Aguilar, Hernán; Fernández de Córdova, Lenin; Rodas, Edgar; Puyana, Juan Carlos; Salamea Molina, Juan Carlos.
Afiliação
  • Sarmiento Altamirano D; Facultad de Medicina, Universidad de Azuay, Cuenca, Ecuador.
  • Himmler A; Division of Surgery, Medstar Georgetown University Hospital and Washington Hospital Center, Washington, DC, USA. amber.n.himmler@gunet.georgetown.edu.
  • Chango Sigüenza O; University of Pittsburgh, Pittsburgh, PA, USA. amber.n.himmler@gunet.georgetown.edu.
  • Pino Andrade R; Division of Trauma and Acute Care Surgery, Hospital Vicente Corral Moscoso, Cuenca, Ecuador.
  • Flores Lazo N; Division of Trauma and Acute Care Surgery, Hospital Vicente Corral Moscoso, Cuenca, Ecuador.
  • Reinoso Naranjo J; Facultad de Medicina, Universidad de Cuenca, Cuenca, Ecuador.
  • Sacoto Aguilar H; Division of Trauma and Acute Care Surgery, Hospital Vicente Corral Moscoso, Cuenca, Ecuador.
  • Fernández de Córdova L; Facultad de Medicina, Universidad de Cuenca, Cuenca, Ecuador.
  • Rodas E; Division of Trauma and Acute Care Surgery, Hospital Vicente Corral Moscoso, Cuenca, Ecuador.
  • Puyana JC; Facultad de Medicina, Universidad de Cuenca, Cuenca, Ecuador.
  • Salamea Molina JC; Facultad de Medicina, Universidad de Azuay, Cuenca, Ecuador.
World J Surg ; 44(6): 1736-1744, 2020 06.
Article em En | MEDLINE | ID: mdl-32107595
BACKGROUND: For years, surgical emergencies in Ecuador were managed on a case-by-case basis without significant standardization. To address these issues, the Regional Hospital Vicente Corral Moscoso adapted and implemented a model of "trauma and acute care surgery" (TACS) to the reality of Cuenca, Ecuador. METHODS: A cohort study was carried out, comparing patients exposed to the traditional model and patients exposed to the TACS model. Variables assessed included number of surgical patients attended to in the emergency department, number of surgical interventions, number of surgeries performed per surgeon, surgical wait time, length of stay and in-hospital mortality. RESULTS: The total number of surgical interventions increased (3919.6-5745.8, p ≤ 0.05); by extension, the total number of surgeries performed per surgeon also increased (5.37-223.68, p ≤ 0.05). We observed a statistically significant decrease in surgical wait time (10.6-3.2 h for emergency general surgery, 6.3-1.6 h for trauma, p ≤ 0.05). Length of stay decreased in trauma patients (9-6 days, p ≤ 0.05). Higher mortality was found in the traditional model (p ≤ 0.05) compared to the TACS model. CONCLUSIONS: The implementation of TACS model in a resource-restrained hospital in Latin America had a positive impact by decreasing surgical waiting time in trauma and emergency surgery patients and length of stay in trauma patients. We also noted a statistically significant decrease in mortality. Savings to the overall system and patients can be inferred by decreased mortality, length of stay and surgical wait times. To our knowledge, this is the first implementation of a TACS model described in Latin America.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ferimentos e Lesões / Cuidados Críticos Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans País/Região como assunto: America do sul / Ecuador Idioma: En Revista: World J Surg Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Equador País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
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Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ferimentos e Lesões / Cuidados Críticos Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Humans País/Região como assunto: America do sul / Ecuador Idioma: En Revista: World J Surg Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Equador País de publicação: Estados Unidos