Comparison of outcomes of patients with acute appendicitis between an acute care surgery model and traditional call coverage model in the same community

Abstract

Background: This study compared outcomes, patient flow, and cost between an acute care surgery (ACS) and traditional call model (TRAD) for acute appendicitis in the same community and time period.

Methods: Patients who underwent appendectomy from 7/1/2012 to 6/30/2014 were retrospectively reviewed. An ACS and TRAD were compared. Demographic data, outcomes, cost, and time intervals were compared.

Results: Of the 945 patients reviewed, the ACS group had more perforated appendicitis on preoperative computed tomography scan (9% vs 3%, P < .001) and pathology (23% vs 10%, P < .001). The TRAD group had more negative appendectomies (6% vs 1%, P < .001). In nonperforated appendicitis, time to discharge was shorter with ACS (16.4 vs 30.2 hours, P < .001), and mean cost was less (P < .001). Complications were similar.

Conclusions: ACS was superior for management of acute appendicitis with shorter time from consultation to operation, shorter time to discharge if nonperforated, and decreased cost.

Keywords: Acute appendicitis; Acute care surgery; Surgical model.