Urgency and Outcomes of General Surgery Patients Admitted to the Emergency Department

Abstract

Objective: This study aimed to evaluate the effectiveness of general surgery consultations initiated from the emergency department (ED) in a high-volume tertiary care hospital, focusing on patient outcomes and the impact of specialty recommendations. Material and Methods: A retrospective analysis was conducted over a six-month period, including 800 patients referred to the general surgery department from the ED. Data on patient demographics, presenting complaints, diagnoses, surgical interventions, and outcomes were collected. Additionally, the influence of the consultation source—whether initiated by the ED or recommended by another specialty—on patient management was assessed. Results: The mean age of the patients was 52.86 years. The most common presenting complaints were abdominal pain (37.5%), nausea/vomiting (14.2%), and trauma-related issues (12.7%). Acute appendicitis was the leading diagnosis (18.1%), frequently necessitating emergency surgery, while hernia (6.1%) and diverticulitis (4.1%) were more often managed with elective procedures. Consultations based on specialty recommendations (73.4%) were less likely to result in surgical intervention. Patients assessed solely by the ED were admitted to the surgical ward in 58.1% of cases, while 59.6% of patients referred following a specialty recommendation were transferred to non-surgical departments. The overall hospital admission rate was 50.7%, with a mortality rate of 4.6%. Conclusion: The study highlights the pivotal role of ED decision-making in managing general surgery patients, particularly in determining the need for surgical intervention. Optimising consultation criteria and reducing reliance on specialty recommendations may improve patient outcomes. The implementation of standardised consultation guidelines is recommended to enhance patient care and resource utilisation in emergency settings.