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Research Paper| Volume 26, ISSUE 1, P13-23, March 2023

Air ambulance retrievals of patients with suspected appendicitis and acute abdominal pain: The patients’ journeys, referral pathways and appendectomy outcomes using linked data in Central Queensland, Australia

Published:July 28, 2022DOI:https://doi.org/10.1016/j.auec.2022.07.002
Air ambulance retrievals of patients with suspected appendicitis and acute abdominal pain: The patients’ journeys, referral pathways and appendectomy outcomes using linked data in Central Queensland, Australia
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      Abstract

      Introduction

      Acute appendicitis is the most common cause of acute abdominal pain presentations to the ED and common air ambulance transfer. Aims: describe how linked data can be used to explore patients’ journeys, referral pathways and request-to-activation responsiveness of patients’ appendectomy outcomes (minor vs major complexity).

      Methods

      Data sources were linked: aeromedical, hospital and death. Request-to-activation intervals showed strong right-tailed skewness. Quantile regression examined whether the longest request-to-activation intervals were associated with appendicitis complexity in patients who underwent an appendectomy.

      Results

      There were 684 patients in three referral pathways based on hospital capability levels. In total, 5.6 % patients were discharged from ED. 83.3 % of all rural origins entered via the ED. 3.8 % of appendicitis patients were triaged to tertiary hospitals. Appendectomy patients with major complexity outcomes were less likely to have longer request-to-activation wait times & had longer lengths of stay than patients with minor complexity outcomes.

      Conclusions

      Linked data highlighted four aspects of a functioning referral system: appendectomy outcomes of major complexity were less likely to have longer request-to-activation intervals compared to minor (sicker patients were identified); few were discharged from EDs (validated transfer); few were triaged to tertiary hospitals (appropriate level for need), and no deaths relating to appendectomy.

      Keywords

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      Article info

      Publication history

      Published online: July 28, 2022
      Accepted: July 3, 2022
      Received in revised form: July 1, 2022
      Received: March 23, 2022

      Footnotes

      ☆The authorship listing conforms with the journal’s authorship policy and all authors are in agreement with the content of the submitted manuscript.

      Identification

      DOI: https://doi.org/10.1016/j.auec.2022.07.002

      Copyright

      © 2022 Published by Elsevier Ltd on behalf of College of Emergency Nursing Australasia.

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