General surgeon involvement in the care of patients designated with an American Association for the Surgery of Trauma-endorsed ICD-10-CM emergency general surgery diagnosis code in Wisconsin. The journal of trauma and acute care surgery Ingraham, A., Schumacher, J., Fernandes-Taylor, S., Yang, D., Godat, L., Smith, A., Barbosa, R., Cribari, C., Salim, A., Schroeppel, T., Staudenmayer, K., Crandall, M., Utter, G. H., AAST Committee on Patient Assessment 2021


BACKGROUND: The current national burden of emergency general surgery (EGS) illnesses and the extent of surgeon involvement in the care of these patients remain largely unknown. To inform needs assessments, research, and education, we sought to: (1) translate previously developed International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) diagnosis codes representing EGS conditions to ICD-10-CM codes and (2) determine the national burden of and assess surgeon involvement across EGS conditions.METHODS: We converted ICD-9-CM codes to candidate ICD-10-CM codes using General Equivalence Mappings then iteratively refined the code list. We used National Inpatient Sample 2016-2017 data to develop a national estimate of the burden of EGS disease. To evaluate surgeon involvement, using Wisconsin Hospital Association (WHA) discharge data (1/1/16-6/30/18), we selected adult urgent/emergent encounters with an EGS condition as the principal diagnosis. Surgeon involvement was defined as a surgeon being either the attending provider or procedural physician.RESULTS: 485 ICD-9-CM codes mapped to 1,696 ICD-10-CM codes. The final list contained 985 ICD-10-CM codes. Nationally, there were 2,977,843 adult patient encounters with an ICD-10-CM EGS diagnosis. Of 94,903 EGS patients in the WHA dataset, most encounters were inpatient as compared to observation (75,878 [80.0%] vs 19,025 [20.0%]). 57,780 patients (60.9%) underwent any procedure. Among all Wisconsin EGS patients, most had no surgeon involvement (64.9% [n = 61,616]). Of the seven most common EGS diagnoses, surgeon involvement was highest for appendicitis (96.0%) and biliary tract disease (77.1%). For the other five most common conditions (skin/soft tissue infections, gastrointestinal hemorrhage, intestinal obstruction/ileus, pancreatitis, diverticular disease), surgeons were involved in roughly 20% of patient care episodes.CONCLUSION: Surgeon involvement for EGS conditions ranges from highly likely (appendicitis) to relatively unlikely (skin/soft tissue infections). The wide range in surgeon involvement underscores the importance of multidisciplinary collaboration in the care of EGS patients.LEVEL OF EVIDENCE: Prognostic/epidemiological, Level III.

View details for DOI 10.1097/TA.0000000000003387

View details for PubMedID 34446657