Emergency General Surgery in the United Kingdom: A lot of General, not many Emergencies, and not much Surgery

Background The provision of emergency general surgery services is a global issue, with important implications for patients and workforce. The aim of this study was to analyze the characteristics of emergency general surgical patients in the United Kingdom, with reference to diagnostic case mix, operative workload, comorbidity, discharge destination, and outcomes, in order to facilitate comparisons, and future service development. Methods This is a cross-sectional, population-based study based in the National Health Service (NHS) in Scotland, one of the home nations of the United Kingdom. All patients aged ≥16 admitted under the care of a general surgeon, as an emergency, to an NHS hospital in Scotland, in 2016 were included. Results There were 81 446 EGS admissions by 66 498 patients. Median episode age was 53 years. There were more female patients than male (55% versus 45%, p75 year-old patients had a 19.8% mortality rate. Conclusions Emergency general surgery in the United Kingdom is a high volume, diagnostically diverse, and low operative volume specialty with high short-term mortality rate in elderly patients. Consideration should be given to alternative service delivery models, which make better use of surgeons’ skills, while also ensuring optimal care for patients who are increasingly elderly, and have complex chronic health problems. Level of evidence III Study type Epidemiology Corresponding author: George Ramsay, University of Aberdeen, Rowett Institute, Ashgrove Road West, Aberdeen, AB252 ZD, Phone: (+44) 01224 552956, Fax: (+44) 01224 553349, Email: george.ramsay@nhs.net We have no conflicts of interest to declare This manuscript will be presented at the 97th International Congress of the Associations of Surgeon of Great Britain and Northern Ireland (ASGBI). May 09-11, 2018 in Liverpool, United Kingdom. We have no funding declarations © 2018 Lippincott Williams & Wilkins, Inc.

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