A systematic review of dedicated models of care for emergency urological patients.
Acute
Acute care surgery
Acute surgical unit
Dedicated
Emergency
Urology
Journal
Asian journal of urology
ISSN: 2214-3882
Titre abrégé: Asian J Urol
Pays: Singapore
ID NLM: 101699720
Informations de publication
Date de publication:
Jul 2021
Jul 2021
Historique:
received:
24
08
2019
revised:
20
01
2020
accepted:
21
04
2020
entrez:
17
8
2021
pubmed:
18
8
2021
medline:
18
8
2021
Statut:
ppublish
Résumé
To systematically evaluate the spectrum of models providing dedicated resources for emergency urological patients (EUPs). A search of Cochrane, Embase, Medline and grey literature from January 1, 2000 to March 26, 2019 was performed using methods pre-published on PROSPERO. Reporting followed Preferred Reporting Items for Systematic Review and meta-analysis guidelines. Eligible studies were articles or abstracts published in English describing dedicated models of care for EUPs, which reported at least one secondary outcome. Studies were excluded if they examined pathways dedicated only to single presentations, such as torsion, or outpatient solutions, such as rapid access clinics. The primary outcome was the spectrum of models. Secondary outcomes were time-to-theatre, length of stay, complications and cost. Seven studies were identified, totalling 487 patients. Six studies were conference abstracts, while one study was of full-text length but published in grey literature. Four distinct models were described. These included consultant urologists allocated solely to the care of EUPs ("Acute Urological Unit") or dedicated registrars or operating theatres ("Hybrid structures"). In some services, EUPs bypassed emergency department assessment and were referred directly to urology ("Urological Assessment Unit") or were managed by other dedicated means. Allocating services to EUPs was associated with reduced time-to-theatre, length of stay and hospital cost, and improved supervision of junior medical staff. Multiple dedicated models of care exist for EUPs. Low-level evidence suggests these may improve outcomes for patients, staff and hospitals. Higher quality studies are required to explore patient outcomes and minimum requirements to establish these models.
Identifiants
pubmed: 34401338
doi: 10.1016/j.ajur.2020.06.006
pii: S2214-3882(20)30055-2
pmc: PMC8356060
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
315-323Informations de copyright
© 2021 Editorial Office of Asian Journal of Urology. Production and hosting by Elsevier B.V.
Déclaration de conflit d'intérêts
The authors declare no conflict of interest.
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