The role of general surgery consultations on patient diagnosis and treatment in the Tertiary Medical Center
Yıl 2024,
Cilt: 5 Sayı: 1, 36 - 41, 30.01.2024
Saygın Altıner
,
İbrahim Kurtoğlu
,
Muhammed Durmuş
,
Kadir Can Şahin
,
Özge Tonbuloğlu Altıner
Asiye Uğraş Dikmen
,
Çağrı Büyükkasap
,
Aydın Yavuz
,
Mevlüt Recep Pekcici
,
Aziz Mutlu Barlas
Öz
Background: The field of general surgery is an important one in medicine. It includes the systems and organs connected to practically every bodily part. Because of this, general surgery is frequently requested for consultation and has a significant role in emergency service applications. The study’s objective is to evaluate general surgery consultations based on their specific attributes.
Methods: A retrospective analysis was performed on 814 patients who were consulted at our hospital’s general surgery clinic between January and June 2021. The departments requesting consultation, the reasons for the consultation, the examinations requested before and after the consultation, and the decisions made after the consultation were evaluated.
Results: The department that required the most consultation from the general surgery branch was the emergency department with 91.5% the most common reason for consultation is nonspecific abdominal pain with 18.1% has been seen. General surgery consultation in patients presenting with abdominal specific complaints, previously ultrasonography and computed tomography were requested in 88.6% of patients.
Conclusion: The fact that physicians request unnecessary consultations and resort to advanced imaging examinations with the reservation of malpractice leads to an increase in both cost and intensity for the health system. Requesting a consultation in conditions where it is more necessary will relieve the intensity of the health system.
Kaynakça
- Kahramanca Ş, Kaya O, Azılı C, Güzel H, Özgehan G, İrem B. The role
of general surgery consultations in patient management. Ulus Cerrahi
Derg. 2013;29:20-24.
- Stolle JK, Mascha EJ, Kester L, Haney D. Randomized controlled of
physician-directed versus respiratory therapy consult service directed
respiratory care to adult non-ICU inpatients. Am J Respir Crit Care
Med. 1998;158:1068-1075.
- Lie RK. The ethics of the physician-patient relationship. Ethical
Perspect. 1997;4:263-270.
- Kayabaşı S, Gül F. Kulak Burun Boğaz hekimlerine yapılan
konsültasyon nedenleri ve sonuçları: Retrospektif bir analiz. Harran
Unıv Tıp Fak Derg. 2019;16:143-147.
- Işıl C, Türk Ş, Sayın P, Çınar S, Oba S. Hastanemiz yoğun bakım
ünitesinden acil konsültasyon istemlerinin değerlendirilmesi. Med
Bull Sisli Etfal Hosp 2012;46:49-52.
- Özkur E, Altunay İ, Şekerlisoy G, Erdem Y. 3. Basamak bir hastanenin
acil servisindeki dermatoloji konsültasyonlarının değerlendirilmesi.
Med Bull Sisli Etfal Hosp 2020;54:197–200
- Peksöz R, Bayar, B. Türkiyenin doğusunda II. basamak bir devlet
hastanesinin acil genel cerrahi hasta profili. Euroasia. App. Sci.
2020;7:47–54.
- Larson DB, Johnson LW, Schnell BM, Salisbury SR, Forman HP.
National trends in CT use in the emergency department: 1995–2007.
Radiology 2010;258:164–73.
- Korley FK, Pham JC, Kirsch TD. Use of advanced radiology during
visits to US emergency departments for injury-related conditions,
1998–2007. JAMA 2010;304:1465–71.
- Dick EA, Varma D, Kashef E, Curtis J. Use of advanced imaging
techniques during visits to emergency departments--implications,
costs, patient benefits/risks. Br J Radiol. 2016;89:20150819.
- Fiorentino M, Mulles S, Cue L, Merchant AM, Tufariello A, Cummings
D et al. High acuity of postoperative consults to emergency general
surgery at an urban safety net hospital. J Surg Res. 2021;257:50-55.
- Çobanoğlu U. Bir üniversite hastanesinde göğüs cerrahisi
konsültasyonu yapılan olguların değerlendirilmesi. Türk Toraks
Dergisi 2009;10:117-121.
- Brenner DJ, Hall EJ. Computed tomography–an increasing source of
radiation exposure. NEJM 2007;357:2277–84.
- Fazel R, Krumholz HM, Wang Y, Ross JS, Chen J, Ting HH, et al.
Exposure to low-dose ionizing radiation from medical imaging
procedures. N Engl J Med 2009;361:849–57.
- Toker A, Shvarts S, Perry ZH. et al. Clinical guidelines,
defensive medicine, and the physician between the two. Am J
Otolaryngol. 2004;25:245–250.
- Corrigan J, Wagner J, Wolfe L. et al. Report from congress medical
malpractice reform and defensive medicine. Cancer Invest. 1996;14:277–
284.
- Ortashi O, Virdee J, Hassan R, Mutrynowski T, Abu-Zidan F. The
practice of defensive medicine among hospital doctors in the United
Kingdom. BMC Med Ethics. 2013;14:42.
- Sethi MK, Obremskey WT, Natividad H, Mir HR, Jahangir AA.
Incidence and costs of defensive medicine among orthopedic surgeons
in the United States: a national survey study. Am J Orthop (Belle Mead
NJ). 2012;41:69-73.
- Egnew TR, Wilson HJ. Role modeling the doctor-patient relationship
in the clinical curriculum. Fam Med 2011; 43: 99-104.
Yıl 2024,
Cilt: 5 Sayı: 1, 36 - 41, 30.01.2024
Saygın Altıner
,
İbrahim Kurtoğlu
,
Muhammed Durmuş
,
Kadir Can Şahin
,
Özge Tonbuloğlu Altıner
Asiye Uğraş Dikmen
,
Çağrı Büyükkasap
,
Aydın Yavuz
,
Mevlüt Recep Pekcici
,
Aziz Mutlu Barlas
Kaynakça
- Kahramanca Ş, Kaya O, Azılı C, Güzel H, Özgehan G, İrem B. The role
of general surgery consultations in patient management. Ulus Cerrahi
Derg. 2013;29:20-24.
- Stolle JK, Mascha EJ, Kester L, Haney D. Randomized controlled of
physician-directed versus respiratory therapy consult service directed
respiratory care to adult non-ICU inpatients. Am J Respir Crit Care
Med. 1998;158:1068-1075.
- Lie RK. The ethics of the physician-patient relationship. Ethical
Perspect. 1997;4:263-270.
- Kayabaşı S, Gül F. Kulak Burun Boğaz hekimlerine yapılan
konsültasyon nedenleri ve sonuçları: Retrospektif bir analiz. Harran
Unıv Tıp Fak Derg. 2019;16:143-147.
- Işıl C, Türk Ş, Sayın P, Çınar S, Oba S. Hastanemiz yoğun bakım
ünitesinden acil konsültasyon istemlerinin değerlendirilmesi. Med
Bull Sisli Etfal Hosp 2012;46:49-52.
- Özkur E, Altunay İ, Şekerlisoy G, Erdem Y. 3. Basamak bir hastanenin
acil servisindeki dermatoloji konsültasyonlarının değerlendirilmesi.
Med Bull Sisli Etfal Hosp 2020;54:197–200
- Peksöz R, Bayar, B. Türkiyenin doğusunda II. basamak bir devlet
hastanesinin acil genel cerrahi hasta profili. Euroasia. App. Sci.
2020;7:47–54.
- Larson DB, Johnson LW, Schnell BM, Salisbury SR, Forman HP.
National trends in CT use in the emergency department: 1995–2007.
Radiology 2010;258:164–73.
- Korley FK, Pham JC, Kirsch TD. Use of advanced radiology during
visits to US emergency departments for injury-related conditions,
1998–2007. JAMA 2010;304:1465–71.
- Dick EA, Varma D, Kashef E, Curtis J. Use of advanced imaging
techniques during visits to emergency departments--implications,
costs, patient benefits/risks. Br J Radiol. 2016;89:20150819.
- Fiorentino M, Mulles S, Cue L, Merchant AM, Tufariello A, Cummings
D et al. High acuity of postoperative consults to emergency general
surgery at an urban safety net hospital. J Surg Res. 2021;257:50-55.
- Çobanoğlu U. Bir üniversite hastanesinde göğüs cerrahisi
konsültasyonu yapılan olguların değerlendirilmesi. Türk Toraks
Dergisi 2009;10:117-121.
- Brenner DJ, Hall EJ. Computed tomography–an increasing source of
radiation exposure. NEJM 2007;357:2277–84.
- Fazel R, Krumholz HM, Wang Y, Ross JS, Chen J, Ting HH, et al.
Exposure to low-dose ionizing radiation from medical imaging
procedures. N Engl J Med 2009;361:849–57.
- Toker A, Shvarts S, Perry ZH. et al. Clinical guidelines,
defensive medicine, and the physician between the two. Am J
Otolaryngol. 2004;25:245–250.
- Corrigan J, Wagner J, Wolfe L. et al. Report from congress medical
malpractice reform and defensive medicine. Cancer Invest. 1996;14:277–
284.
- Ortashi O, Virdee J, Hassan R, Mutrynowski T, Abu-Zidan F. The
practice of defensive medicine among hospital doctors in the United
Kingdom. BMC Med Ethics. 2013;14:42.
- Sethi MK, Obremskey WT, Natividad H, Mir HR, Jahangir AA.
Incidence and costs of defensive medicine among orthopedic surgeons
in the United States: a national survey study. Am J Orthop (Belle Mead
NJ). 2012;41:69-73.
- Egnew TR, Wilson HJ. Role modeling the doctor-patient relationship
in the clinical curriculum. Fam Med 2011; 43: 99-104.