• Ashley M Tameron, Kevin B Ricci, Wendelyn M Oslock, Amy P Rushing, Angela M Ingraham, Vijaya T Daniel, Anghela Z Paredes, Adrian Diaz, Courtney E Collins, Victor K Heh, Holly E Baselice, Scott A Strassels, and Heena P Santry.
• Ohio State University Wexner Medical Center, Department of Surgery, 395 W 12th Avenue, Columbus, OH, USA.
• J Crit Care. 2020 Dec 1; 60: 84-90.

PurposeWe examined differences in critical care structures and processes between hospitals with Acute Care Surgery (ACS) versus general surgeon on call (GSOC) models for emergency general surgery (EGS) care.Methods2811 EGS-capable hospitals were surveyed to examine structures and processes including critical care domains and ACS implementation. Differences between ACS and GSOC hospitals were compared using appropriate tests of association and logistic regression models.Results272/1497 hospitals eligible for analysis (18.2%) reported they use an ACS model. EGS patients at ACS hospitals were more likely to be admitted to a combined trauma/surgical ICU or a dedicated surgical ICU. GSOC hospitals had lower adjusted odds of having 24-h ICU coverage, in-house intensivists or respiratory therapists, and 4/6 critical-care protocols.ConclusionsCritical care delivery is a key component of EGS care. While harnessing of critical care structures and processes varies across hospitals that have implemented ACS, overall ACS models of care appear to have more robust critical care practices.Published by Elsevier Inc.

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