Distribution of emergency operations and trauma in a Swedish hospital: need for reorganisation of acute surgical care?

摘要: Subspecialisation within general surgery has today reached further than ever. However, on-call time, an unchanged need for broad surgical skills are required to meet the demands of acute disease and trauma. The introduction a new subspecialty in North America that deals solely with care trauma is attempt offer properly trained surgeons also during time. To find out whether such could be helpful Sweden we analyzed our workload emergency Linkoping University Hospital serves population 257 000. Data from 2010 all patients, diagnoses, times types operations, involved, duration stay, injury deaths regarding procedures were extracted prospectively-collected database analyzed. There 2362 admissions, 1559 interventions; 835 mainly abdominal 724 diagnostic or therapeutic endoscopies. Of interventions, 641 (41.1%) made outside office hours, 453 minor intermediate (including appendicectomy, cholecystectomy, proctological procedures) 276 (60.9%) done evenings at night. Two hundred fifty-four patients admitted 29 (11.4%) operation, whom operated on eight (3.1%). Thirteen consultants 11 senior registrars involved 138 bowel resections 164 cholecystectomies chosen as index operations standard surgery. median (range) number by each consultant was 6 (3–17) (1–22). Corresponding figures 7 (0–11) 8 (1–39). uneven distribution exposure problems among surgeons. Some exposed only few interventions most did not operate single patient Further centralization care, long-term positions units trauma, subspecialisation fields might options solve low volumes.