Is case triaging a useful tool for emergency surgeries? A review of 106 trauma surgery cases at a level 1 trauma center in South Africa
| dc.contributor.author | Chowdhury, Sharfuddin | |
| dc.contributor.author | Nicol, Andrew J | |
| dc.contributor.author | Moydien, Mahammed R | |
| dc.contributor.author | Navsaria, Pradeep H | |
| dc.contributor.author | Montoya-Pelaez, Luis F | |
| dc.date.accessioned | 2018-04-12T09:47:28Z | |
| dc.date.available | 2018-04-12T09:47:28Z | |
| dc.date.issued | 2018-01-24 | |
| dc.date.updated | 2018-04-09T15:05:08Z | |
| dc.description.abstract | Abstract Background The optimal timing for emergency surgical interventions and implementation of protocols for trauma surgery is insufficient in the literature. The Groote Schuur emergency surgery triage (GSEST) system, based on Cape Triaging Score (CTS), is followed at Groote Schuur Hospital (GSH) for triaging emergency surgical cases including trauma cases. The study aimed to look at the effect of delay in surgery after scheduling based on the GSEST system has an impact on outcome in terms of postoperative complications and death. Methods Prospective audit of patients presenting to GSH trauma center following penetrating or blunt chest, abdominal, neck and peripheral vascular trauma who underwent surgery over a 4-month period was performed. Post-operative complications were graded according to Clavien-Dindo classification of surgical complications. Results One-hundred six patients underwent surgery during the study period. One-hundred two (96.2%) cases were related to penetrating trauma. Stab wounds comprised 71 (67%) and gunshot wounds (GSW) 31 (29.2%) cases. Of the 106 cases, 6, 47, 40, and 13 patients were booked as red, orange, yellow, and green, respectively. The median delay for green, yellow, and orange cases was within the expected time. The red patients took unexpectedly longer (median delay 48 min, IQR 35ā60 min). Thirty-one (29.3%) patients developed postoperative complications. Among the booked red, orange, yellow, and green cases, postoperative complications developed in 3, 18, 9, and 1 cases, respectively. Only two (1.9%) postoperative deaths were documented during the study period. There was no statistically significant association between operative triage and post-operative complications (pā=ā0.074). Conclusion Surgical case categorization has been shown to be useful in prioritizing emergency trauma surgical cases in a resource constraint high-volume trauma center. | |
| dc.identifier.apacitation | Chowdhury, S., Nicol, A. J., Moydien, M. R., Navsaria, P. H., & Montoya-Pelaez, L. F. (2018). Is case triaging a useful tool for emergency surgeries? A review of 106 trauma surgery cases at a level 1 trauma center in South Africa. http://hdl.handle.net/11427/27783 | en_ZA |
| dc.identifier.chicagocitation | Chowdhury, Sharfuddin, Andrew J Nicol, Mahammed R Moydien, Pradeep H Navsaria, and Luis F Montoya-Pelaez "Is case triaging a useful tool for emergency surgeries? A review of 106 trauma surgery cases at a level 1 trauma center in South Africa." (2018) http://hdl.handle.net/11427/27783 | en_ZA |
| dc.identifier.citation | World Journal of Emergency Surgery. 2018 Jan 24;13(1):4 | |
| dc.identifier.ris | TY - Journal Article AU - Chowdhury, Sharfuddin AU - Nicol, Andrew J AU - Moydien, Mahammed R AU - Navsaria, Pradeep H AU - Montoya-Pelaez, Luis F AB - Abstract Background The optimal timing for emergency surgical interventions and implementation of protocols for trauma surgery is insufficient in the literature. The Groote Schuur emergency surgery triage (GSEST) system, based on Cape Triaging Score (CTS), is followed at Groote Schuur Hospital (GSH) for triaging emergency surgical cases including trauma cases. The study aimed to look at the effect of delay in surgery after scheduling based on the GSEST system has an impact on outcome in terms of postoperative complications and death. Methods Prospective audit of patients presenting to GSH trauma center following penetrating or blunt chest, abdominal, neck and peripheral vascular trauma who underwent surgery over a 4-month period was performed. Post-operative complications were graded according to Clavien-Dindo classification of surgical complications. Results One-hundred six patients underwent surgery during the study period. One-hundred two (96.2%) cases were related to penetrating trauma. Stab wounds comprised 71 (67%) and gunshot wounds (GSW) 31 (29.2%) cases. Of the 106 cases, 6, 47, 40, and 13 patients were booked as red, orange, yellow, and green, respectively. The median delay for green, yellow, and orange cases was within the expected time. The red patients took unexpectedly longer (median delay 48 min, IQR 35ā60 min). Thirty-one (29.3%) patients developed postoperative complications. Among the booked red, orange, yellow, and green cases, postoperative complications developed in 3, 18, 9, and 1 cases, respectively. Only two (1.9%) postoperative deaths were documented during the study period. There was no statistically significant association between operative triage and post-operative complications (pā=ā0.074). Conclusion Surgical case categorization has been shown to be useful in prioritizing emergency trauma surgical cases in a resource constraint high-volume trauma center. DA - 2018-01-24 DB - OpenUCT DO - 10.1186/s13017-018-0166-5 DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2018 T1 - Is case triaging a useful tool for emergency surgeries? A review of 106 trauma surgery cases at a level 1 trauma center in South Africa TI - Is case triaging a useful tool for emergency surgeries? A review of 106 trauma surgery cases at a level 1 trauma center in South Africa UR - http://hdl.handle.net/11427/27783 ER - | en_ZA |
| dc.identifier.uri | http://dx.doi.org/10.1186/s13017-018-0166-5 | |
| dc.identifier.uri | http://hdl.handle.net/11427/27783 | |
| dc.identifier.vancouvercitation | Chowdhury S, Nicol AJ, Moydien MR, Navsaria PH, Montoya-Pelaez LF. Is case triaging a useful tool for emergency surgeries? A review of 106 trauma surgery cases at a level 1 trauma center in South Africa. 2018; http://hdl.handle.net/11427/27783. | en_ZA |
| dc.language.iso | en | |
| dc.publisher | BioMed Central | |
| dc.publisher.department | Department of Medicine | en_ZA |
| dc.publisher.faculty | Faculty of Health Sciences | en_ZA |
| dc.publisher.institution | University of Cape Town | |
| dc.rights.holder | The Author(s). | |
| dc.subject.other | Emergency surgery case triage | |
| dc.subject.other | Trauma surgery | |
| dc.subject.other | Postoperative complication | |
| dc.subject.other | Outcome | |
| dc.title | Is case triaging a useful tool for emergency surgeries? A review of 106 trauma surgery cases at a level 1 trauma center in South Africa | |
| dc.type | Journal Article | |
| uct.type.filetype | ||
| uct.type.filetype | Text | |
| uct.type.filetype | Image |