Involvement of acute care surgeons reduces post-surgery complications: A propensity-score matched evaluation of clinical outcomes

Abstract

Abstract Purpose: Acute care surgeons are experts in trauma treatment, emergency surgery, and critical surgical care. Herein, we analyzed the impact of involvement of an acute care surgeon vs a general surgeon on postoperative outcomes in emergency general surgery. Methods: This retrospective study included 92 patients who underwent emergency general surgery at our institution between January 2020 and September 2021. Patients were separated into two groups based on the attending surgeon, and propensity score matching was used to analyze postoperative outcomes. The primary outcome was postoperative complications, while secondary outcomes included perioperative management and surgery-related and postoperative complications. Logistic regression analysis was applied to estimate the odds ratios (OR) for all complications. Results: Overall, 30 patients were treated by acute care surgeons (ACS group) and 62 patients were treated by general surgeons (non-ACS group). Propensity score matching identified 30 patients with balanced baseline covariates in each group. After matching, the ACS group had lower complication rates (Clavien–Dindo classification ≥2) than the non-ACS group (17% vs. 40%, P=0.08), as well as a significantly shorter surgery duration (75 min vs. 96 min, P=0.014). In logistic analysis, acute care surgeon involvement was identified as an independent predictor for a decrease in all complications (OR, 0.15; 95%CI, 0.02–0.64). Conclusion: Acute care surgeon involvement reduces the overall complication rate in emergency general surgery.