title: Dedicated emergency departments delay surgical treatment of acute appendicitis.
abstract: BACKGROUND
  A new emergency service has been introduced in Denmark. We aimed to assess the impact of the service change for the care of acute surgical emergencies, specifically a subset of patients treated with an appendectomy.
  
  
  METHODS
  This was a retrospective review of all the patients who had an appendectomy in a surgical department during one year prior to and one year after the implementation of a new emergency service. Data collected included patients' demographics and information related to the care such as the number of doctors involved in diagnosing appendicitis, whether preoperative radiological investigation was used, time to operation, morbidity during the first 30 days, including readmission, type of complication and required intervention.
  
  
  RESULTS
  A total of 314 patients had an appendectomy performed during the study period. After the implementation of the new emergency service, there was a significant delay in time to definitive treatment (457 minutes versus 593 minutes, p = 0.001). The total number of doctors involved in diagnosing appendicitis increased to a median of three doctors (range 1-6) from a median of two surgeons (range 1-6) (p < 0.0001). There was no difference in the number of readmissions or complications.
  
  
  CONCLUSIONS
  Introducing a new emergency service required an extra doctor for diagnosing appendicitis which delayed the overall time to definitive treatment by nearly 2.5 hours.
  
  
  BACKGROUND
  not relevant.
  
  
  BACKGROUND
  not applicable as this is an audit study.
authors.affiliation: Hospitalsenheden Vest, Kirurgisk Afdeling, Regionshospitalet Herning, Gl. Landevej 61, 7400 Herning. mogens.r.madsen@vest.rm.dk.
authors.forename: Shiraz Ajmal
authors.initials: SA
authors.lastname: Qadar
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Maeda
authors.forename: Javed
authors.initials: J
authors.lastname: Akram
authors.forename: Mogens Rørbaek
authors.initials: MR
authors.lastname: Madsen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001062:Appendectomy / Q000706:statistics & numerical data*; D001064:Appendicitis / Q000175:diagnosis / Q000601:surgery*; D003718:Denmark; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation / Q000458:organization & administration; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult