The Changing Face of Emergency General Surgery: A 20-Year Analysis of Secular Trends in Demographics, Diagnoses, Operations and Outcomes

Jared Wohlgemut, George Ramsay, Jan Jansen* (Corresponding Author)

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

23 Citations (Scopus)
7 Downloads (Pure)


Objective: The aim of the study was to evaluate secular trends in the epidemiology of emergency general surgery (EGS), by analyzing changes in demographics, diagnoses, operations, and outcomes between 1997 and 2016. Summary Background Data: The provision and delivery of EGS services is a globally and regionally important issue. The impact of changing demographics and surgical disease incidence on EGS services is not well understood. Methods: Data from all EGS hospital episodes of adults (aged >15) in Scotland between 1997 and 2016 were prospectively collected, including ICD-10 diagnostic codes and OPCS-4 procedure codes. The number and ageand sex-standardized rates per 100,000 population, per year, of the most common diagnoses and operations were calculated. We analyzed demographic changes over time using linear regression, and changes in characteristics, diagnoses, operations, and outcomes using Poisson analysis. Results: Data included 1,484,116 EGS hospital episodes. The number and age- and sex-standardized rate, per 100,000 population, of EGS admissions have increased over time, whereas that of EGS operations have decreased over time. Male admissions were unchanged, but with fewer operations over time, whereas female admissions increased significantly over time with no change in the operation rate. Poisson analysis demonstrated secular trends in demographics, admissions, operations, and outcomes in depth. Conclusions: This 20-year pidemiological study of all EGS hospital episodes in Scotland has enhanced our understanding of secular trends of EGS, including demographics, diagnoses, operations, and outcomes. These data will help inform stakeholders in EGS service planning and delivery, as well as in surgical training, what has occurred in recent history
Original languageEnglish
Pages (from-to)581-589
Number of pages9
JournalAnnals of Surgery
Issue number3
Early online date26 Sept 2018
Publication statusPublished - 1 Mar 2020

Bibliographical note

The authors thank Dr Neil Scott and Mrs Rute Vieira for their statistical expertise. There were no financial or material contribution from any source for this work. We would also like to thank the Information Services Division of the NHS in Scotland for extracting the data, and the Data Safehaven at the University of Aberdeen for hosting it.

This study was funded by NHS Grampian Endowments, Aberdeen, UK. No
funding was received from the National Institutes of Health, Wellcome Trust
or Howard Hughes Medical Institute


  • acute care surgery
  • admissions
  • diagnosis
  • emergency general surgery
  • epidemiology
  • operations
  • surgical outcomes
  • trauma


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