7 emergency general surgeries account for 80% of admissions, deaths, costs

Researchers looking at data on urgent or emergency general surgery (EGS) operations in the U.S. have found seven types of procedures account for more than 80 percent of all admissions, deaths, complications and costs related to EGS.

The study, published April 27 in JAMA Surgery, examined a federal database of 421,476 patient encounters with EGS between 2008 and 2011. The seven most common procedures are: 

• Partial colectomy
• Small-bowel resection
• Cholecystectomy
• Operative management of peptic ulcer disease
• Lysis of peritoneal adhesions
• Appendectomy
• Laparotomy

Because only a handful of procedures are responsible for most admissions, deaths and complications, the study concluded “[n]ational quality benchmarks and cost reduction efforts should focus on these common, complicated and costly EGS procedures.”

More than three million Americans are admitted to hospitals every year for EGS diagnoses. Individuals undergoing EGS operations have a mortality rate eight times higher than patients undergoing the same procedures electively.

In the face of such troubling statistics, researchers emphasized the importance of establishing surgical benchmarks for EGS procedures that currently do not exist.

“A more focused, clinically relevant and nationally representative list of EGS procedures is needed,” the researchers wrote. “The goal of the present study was to expand the current diagnosis-based definition of EGS to define a standardized, representative set of procedures that make up the bulk of the national clinical burden of EGS.”