Progress Report October 2022 Student Investigators Chris Perry Taylah Brentnall Supervisors Dr Debra Tennett Dr Janani Pinidiyapathirage Rural emergency surgical services 31 of Australians live rurally ID: 1035913
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1. In-house GENERAL surgical interventions by Flying Specialist Services in Southwest Queensland Progress Report October 2022Student Investigators: Chris Perry, Taylah BrentnallSupervisors: Dr Debra Tennett Dr Janani Pinidiyapathirage
2. Rural emergency surgical services 31% of Australians live rurally14.6% of surgeons live in these locations Marked health disparity Capacity of the rural service to provide appropriate surgical care to their community?“Rural and regional patients have the right to expect appropriate access to high quality medical services”
3. CSCF and the flying surgical service SWHHS Self Assessment: Level 3Roma, Charleville, St George and Cunnamulla Hospitals Flying Surgical ServiceGeneral Surgeon Obstetrician/Gynecologist Anesthetist
4. MethodologyRetrospective chart auditJan 2018 – Dec 2021 Appendectomies and Cholecystectomies Inclusion:Retrieved from the SW for surgical emergenciesOperated within the SW ExclusionNon operative retrievals ERCP Outcome measures: Surgery frequencyDemographicsDate/Time of surgeryLength of stay Complications
5. results AppendectomyCholecystectomy Surgeries 61 (65%)33 (35%)Gender Male346Gender Female2723*Public5429Private74Laparoscopic52*29*Open20Emergency54*29*Elective 00Transfers n=94 AppendectomyCholecystectomy Surgeries 105 (45%)131 (55%)Gender Male4925Gender Female56106*Public104128Private13Laparoscopic98*131*Open70Emergency103*18Elective 2131*SW Surgery n=234* Fishers Exact Test: p<0.005 ⍺=0.05
6. resultsAge GroupAppendectomyCholecystectomyTotal0-1717 (28.8%)0 (0.0%)17 (19.1%)18-2918 (30.5%)8 (26.7%)26 (29.2%)30-397 (11.9%)6 (20.0%)13 (14.6%)40-493 (5.1%)3 (10.0%)6 (6.7%)50-5914 (28.8%)13 (43.3%)27 (30.3%)60+18 (30.5%)8 (26.7%)26 (29.2%)Transfers n=94SW Surgery n=234Age GroupAppendectomyCholecystectomyTotal0-1725 (23.8%)1 (0.8%)26 (11.0%)18-2934 (32.4%)30 (22.9%64 (27.1%)30-3916 (15.2%)25 (19.1%)41 (17.4%)40-4914 (13.3%)24 (18.3%)38 (16.1%)50-5910 (9.5%)26 (19.9%)36 (15.3%)60+6 (5.7%)25 (19.1%)31 (13.1%)
7. results AppendectomyCholecystectomy Surgeries 105131Outside operating time78 (74.3%)*16 (12.2%)*Weekend9 (8.6%)*1 (0.8%)*Histology confirmed 84 (80%)129 (98.5%)*Post op complications5 (4.8%)7 (5.4%)Length of stay (median)2 days1 dayPerformed by FSS Primary 70 (66.7%)131 (100%)Transfers n=94SW Surgery n=234 AppendectomyCholecystectomy Surgeries 6133Outside operating time33 (54.1%)16 (48.5%)Weekend24 (72.7%)8 (24.2%)Histology confirmed 52 (85.2%29 (87.9%)Post op complications7 (11.5%)3 (9.1%)Length of stay (median)2days3days* Z score: p<0.005 ⍺=0.05
8. Discussion Female Cholecystectomies 1:4Laparoscopic vs Open Operating on weekends and Outside operating hours Should we have 24/7 access to General Surgery in Rural areas?To touch or not to touch the HOT GallbladderFuture analysis:Year analysis comparing the trendImpacts of covidBMIElective Cholecysetomies in TBHSMO vs General Surgeon