Clinical outcomes of the implementation of acute care surgery system in South Korea: a multi-centre, retrospective cohort study

In emergency general surgery (EGS), rapid judgement and prompt emergency surgery play a significant role in determining the patient's prognosis. This study aimed to evaluate whether implementing the acute care surgery (ACS) system in Korea has improved the clinical outcomes of patients. This retrospective cohort study was conducted at three tertiary hospitals in Korea. The study included patients aged 18-99 years who required EGS due to acute abdomen or abdominal trauma. A window period of 4 months was set after the implementation of the ACS system, and the clinical outcomes before and after the implementation were compared. A total of 2146 patients were enrolled in the study, with 1008 in the pre-ACS group and 1138 in the post-ACS group. After propensity score matching, 901 patients were selected in the pre-ACS group and 906 patients were selected in the post-ACS group. The time from emergency room admission to operating room transfer was reduced in the post-ACS group, with a mean of 452.2 ± 347.0 min compared to 522.1 ± 416.5 min in the pre ACS group (P = 0.001). Moreover, the complication rates were reduced in the post-ACS group (38.3% vs. 31.3%, P = 0.006). The implementation of the ACS system can lead to faster surgical decision-making and the prompt execution of emergency surgery for patients, thereby reducing postoperative complications.