Emergency General Surgery Transfers to Definitive Care: An Assessment of Patient and Systemic Factors in Appendicitis Referrals.

Abstract

Patients presenting to the emergency department (ED) with an Emergency General Surgery (EGS) problem often require transfer to a tertiary facility. Issues impacting EGS mirror the same issues trauma surgery faced prior to the implementation of current trauma guidelines. This study analyzed the cost, time, and transport resource utilization of EGS patients with acute appendicitis when transferred from network hospitals to a level II trauma center. This was a retrospective study. Patients were transferred by a critical or specialty care transport team 62% of the time, although no skills performed required a critical or specialty care provider. The median time from decision to transfer to incision was 254 minutes, with an average transport time of 27minutes. This study suggests that there is an opportunity to improve access to the operating room and to decrease resource utilization of specialty care and critical care transport for patients.