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Table 3 Comparison of clinical outcomes and total cost between three time periods, based on the presence of an ACS service

From: Acute care surgery: a means for providing cost-effective, quality care for gallstone pancreatitis

 

Period 1

Period 2

Period 3

p value

Number, n

139

241

55

–

Index OR, n (%)

22 (16)

120 (50)

42 (76)

<0.001

Elective OR, n (%)

85 (61)

67 (28)

6 (11)

<0.001

Inpatient ERCP, n (%)

61 (44)

87 (36)

16 (29)

0.11

ER to OR, d, mean (SD)

95 (194)

32 (66)

23 (107)

<0.001

OR duration, minutes

65 (32)

68 (29)

63 (34)

0.44

Open, n (%)

6 (4)

9 (4)

0 (0)

–

Postoperative stay, d, mean (SD)

1.5 (1.8)

1.4 (5.7)

1.1 (1.9)

0.87

Total LOS on index admission, days, mean (SD)

5 (3)

6 (9)

5 (3)

0.10

More than one admission for GSP, n (%)

47 (34)

30 (12)

4 (7)

<0.001

More than one ER visit for GSP, n (%)

58 (42)

32 (13)

9 (16)

<0.001

Time of index OR

 Mon–Fri (7 a.m.–5 p.m.)

10 (46)

73 (61)

26 (62)

0.675

 Mon–Fri (5 p.m.–Midnight)

2 (9)

9 (8)

2 (5)

 

 Mon–Fri (Midnight–7 a.m.)

0 (0)

0 (0)

0 (0)

 

 Weekend

10 (46)

38 (32)

14 (33)

 

Total cost (2011 dollars), mean (SD)

$9255 (324)

$9307 (648)

$8093 (505)

<0.001

  1. Period 1: 2008–2010 (no ACS at either site)
  2. Period 2: 2010–2014 (ACS at site A)
  3. Period 3: 2014–2015 (ACS at both sites)
  4. LOS Length of stay, ERCP endoscopic retrograde cholangiopancreatography, ER emergency room, OR operating room