The Changing Face of Emergency General Surgery

A 20-Year Analysis of Secular Trends in Demographics, Diagnoses, Operations and Outcomes

Jared Wohlgemut, George Ramsay, Jan Jansen (Corresponding Author)

Research output: Contribution to journalArticle

Abstract

Objective: The aim of the study was to evaluate secular trends in the epidemiology of emergency general surgery (EGS), by analyzing changes in demographics, diagnoses, operations, and outcomes between 1997 and 2016. Summary Background Data: The provision and delivery of EGS services is a globally and regionally important issue. The impact of changing demographics and surgical disease incidence on EGS services is not well understood. Methods: Data from all EGS hospital episodes of adults (aged >15) in Scotland between 1997 and 2016 were prospectively collected, including ICD-10 diagnostic codes and OPCS-4 procedure codes. The number and ageand sex-standardized rates per 100,000 population, per year, of the most common diagnoses and operations were calculated. We analyzed demographic changes over time using linear regression, and changes in characteristics, diagnoses, operations, and outcomes using Poisson analysis. Results: Data included 1,484,116 EGS hospital episodes. The number and age- and sex-standardized rate, per 100,000 population, of EGS admissions have increased over time, whereas that of EGS operations have decreased over time. Male admissions were unchanged, but with fewer operations over time, whereas female admissions increased significantly over time with no change in the operation rate. Poisson analysis demonstrated secular trends in demographics, admissions, operations, and outcomes in depth. Conclusions: This 20-year pidemiological study of all EGS hospital episodes in Scotland has enhanced our understanding of secular trends of EGS, including demographics, diagnoses, operations, and outcomes. These data will help inform stakeholders in EGS service planning and delivery, as well as in surgical training, what has occurred in recent history
Original languageEnglish
Number of pages9
JournalAnnals of Surgery
Early online date26 Sep 2018
DOIs
Publication statusE-pub ahead of print - 26 Sep 2018

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Emergencies
Demography
General Hospitals
Scotland
International Classification of Diseases
Population
Linear Models
Epidemiology
History
Incidence

Cite this

@article{40b4762f080a4da29e80e3c871f330dd,
title = "The Changing Face of Emergency General Surgery: A 20-Year Analysis of Secular Trends in Demographics, Diagnoses, Operations and Outcomes",
abstract = "Objective: The aim of the study was to evaluate secular trends in the epidemiology of emergency general surgery (EGS), by analyzing changes in demographics, diagnoses, operations, and outcomes between 1997 and 2016. Summary Background Data: The provision and delivery of EGS services is a globally and regionally important issue. The impact of changing demographics and surgical disease incidence on EGS services is not well understood. Methods: Data from all EGS hospital episodes of adults (aged >15) in Scotland between 1997 and 2016 were prospectively collected, including ICD-10 diagnostic codes and OPCS-4 procedure codes. The number and ageand sex-standardized rates per 100,000 population, per year, of the most common diagnoses and operations were calculated. We analyzed demographic changes over time using linear regression, and changes in characteristics, diagnoses, operations, and outcomes using Poisson analysis. Results: Data included 1,484,116 EGS hospital episodes. The number and age- and sex-standardized rate, per 100,000 population, of EGS admissions have increased over time, whereas that of EGS operations have decreased over time. Male admissions were unchanged, but with fewer operations over time, whereas female admissions increased significantly over time with no change in the operation rate. Poisson analysis demonstrated secular trends in demographics, admissions, operations, and outcomes in depth. Conclusions: This 20-year pidemiological study of all EGS hospital episodes in Scotland has enhanced our understanding of secular trends of EGS, including demographics, diagnoses, operations, and outcomes. These data will help inform stakeholders in EGS service planning and delivery, as well as in surgical training, what has occurred in recent history",
author = "Jared Wohlgemut and George Ramsay and Jan Jansen",
note = "ACKNOWLEDGMENTS The authors thank Dr Neil Scott and Mrs Rute Vieira for their statistical expertise. There were no financial or material contribution from any source for this work. We would also like to thank the Information Services Division of the NHS in Scotland for extracting the data, and the Data Safehaven at the University of Aberdeen for hosting it. This study was funded by NHS Grampian Endowments, Aberdeen, UK. No funding was received from the National Institutes of Health, Wellcome Trust or Howard Hughes Medical Institute",
year = "2018",
month = "9",
day = "26",
doi = "10.1097/SLA.0000000000003066",
language = "English",
journal = "Annals of Surgery",
issn = "0003-4932",
publisher = "Lippincott Williams and Wilkins",

}

TY - JOUR

T1 - The Changing Face of Emergency General Surgery

T2 - A 20-Year Analysis of Secular Trends in Demographics, Diagnoses, Operations and Outcomes

AU - Wohlgemut, Jared

AU - Ramsay, George

AU - Jansen, Jan

N1 - ACKNOWLEDGMENTS The authors thank Dr Neil Scott and Mrs Rute Vieira for their statistical expertise. There were no financial or material contribution from any source for this work. We would also like to thank the Information Services Division of the NHS in Scotland for extracting the data, and the Data Safehaven at the University of Aberdeen for hosting it. This study was funded by NHS Grampian Endowments, Aberdeen, UK. No funding was received from the National Institutes of Health, Wellcome Trust or Howard Hughes Medical Institute

PY - 2018/9/26

Y1 - 2018/9/26

N2 - Objective: The aim of the study was to evaluate secular trends in the epidemiology of emergency general surgery (EGS), by analyzing changes in demographics, diagnoses, operations, and outcomes between 1997 and 2016. Summary Background Data: The provision and delivery of EGS services is a globally and regionally important issue. The impact of changing demographics and surgical disease incidence on EGS services is not well understood. Methods: Data from all EGS hospital episodes of adults (aged >15) in Scotland between 1997 and 2016 were prospectively collected, including ICD-10 diagnostic codes and OPCS-4 procedure codes. The number and ageand sex-standardized rates per 100,000 population, per year, of the most common diagnoses and operations were calculated. We analyzed demographic changes over time using linear regression, and changes in characteristics, diagnoses, operations, and outcomes using Poisson analysis. Results: Data included 1,484,116 EGS hospital episodes. The number and age- and sex-standardized rate, per 100,000 population, of EGS admissions have increased over time, whereas that of EGS operations have decreased over time. Male admissions were unchanged, but with fewer operations over time, whereas female admissions increased significantly over time with no change in the operation rate. Poisson analysis demonstrated secular trends in demographics, admissions, operations, and outcomes in depth. Conclusions: This 20-year pidemiological study of all EGS hospital episodes in Scotland has enhanced our understanding of secular trends of EGS, including demographics, diagnoses, operations, and outcomes. These data will help inform stakeholders in EGS service planning and delivery, as well as in surgical training, what has occurred in recent history

AB - Objective: The aim of the study was to evaluate secular trends in the epidemiology of emergency general surgery (EGS), by analyzing changes in demographics, diagnoses, operations, and outcomes between 1997 and 2016. Summary Background Data: The provision and delivery of EGS services is a globally and regionally important issue. The impact of changing demographics and surgical disease incidence on EGS services is not well understood. Methods: Data from all EGS hospital episodes of adults (aged >15) in Scotland between 1997 and 2016 were prospectively collected, including ICD-10 diagnostic codes and OPCS-4 procedure codes. The number and ageand sex-standardized rates per 100,000 population, per year, of the most common diagnoses and operations were calculated. We analyzed demographic changes over time using linear regression, and changes in characteristics, diagnoses, operations, and outcomes using Poisson analysis. Results: Data included 1,484,116 EGS hospital episodes. The number and age- and sex-standardized rate, per 100,000 population, of EGS admissions have increased over time, whereas that of EGS operations have decreased over time. Male admissions were unchanged, but with fewer operations over time, whereas female admissions increased significantly over time with no change in the operation rate. Poisson analysis demonstrated secular trends in demographics, admissions, operations, and outcomes in depth. Conclusions: This 20-year pidemiological study of all EGS hospital episodes in Scotland has enhanced our understanding of secular trends of EGS, including demographics, diagnoses, operations, and outcomes. These data will help inform stakeholders in EGS service planning and delivery, as well as in surgical training, what has occurred in recent history

U2 - 10.1097/SLA.0000000000003066

DO - 10.1097/SLA.0000000000003066

M3 - Article

JO - Annals of Surgery

JF - Annals of Surgery

SN - 0003-4932

ER -