{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T21:09:26Z","timestamp":1790111366816,"version":"4.0.1"},"reference-count":35,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Surg"],"published-print":{"date-parts":[[2026,3,1]]},"abstract":"\n Importance<\/jats:title>\n Outcomes in emergency general surgery vary between hospitals, and models with dedicated resources and personnel have been developed with the aim of improving care. Existing literature is limited in scope and often does not involve nonoperatively treated patients, reducing generalizability.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To use population-level data to determine whether treatment in an emergency general surgery model is associated with clinical outcomes.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This was a retrospective cohort study of adults in Ontario, Canada, diagnosed with 1 of 9 emergency general surgery conditions and hospitalized between April 1, 2002, and December 31, 2019, using linked administrative data housed at ICES. Data analysis was conducted from June 24, 2024, to October 24, 2025.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Treatment at a hospital with an emergency general surgery model of care in comparison with a standard surgeon on-call model.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Death in the hospital or within 30 days of discharge was the primary outcome. Secondary outcomes included death at 90 days and complications, failure to rescue, and readmission at 30 days. Generalized estimating equations were used with a negative binomial distribution for mortality outcomes and a binomial distribution for other secondary outcomes. Clustering at the hospital level was accounted for, and effect modification according to diagnosis risk category (low, medium, or high) was evaluated.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 494\u202f609 patients were included (median [IQR] age, 56 [40-72] years; 263\u202f267 [53.2%] female), with 88\u202f889 (18.0%) treated in an emergency general surgery model hospital. A total of 3069 patients (3.4%) in an emergency general surgery model died within 30 days, compared with 15\u202f013 (3.7%) in a surgeon on-call model. Adjusted analyses showed an association between an emergency general surgery model and decreased adjusted relative risk (aRR) of 30-day death for patients with high-risk conditions (aRR, 0.85; 95% CI, 0.77-0.95) but not for those with low- or medium-risk conditions. Death at 90 days was likewise lower in emergency general surgery models for high-risk conditions (aRR, 0.82; 95% CI, 0.74-0.92). The odds of complications in patients with high-risk conditions showed a similar association (adjusted odds ratio, 0.68; 95% CI, 0.53-0.87), but there was no association with failure to rescue or readmission.<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n This cohort study demonstrated that death and complications were lower for patients with high-risk conditions in an emergency general surgery model of care. These findings suggest that these patients would benefit from formal systems to prioritize management at emergency general surgery model centers but that patients with lower-risk conditions are less likely to benefit from this care.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamasurg.2025.6155","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T16:00:51Z","timestamp":1769011251000},"page":"250","source":"Crossref","is-referenced-by-count":4,"title":["A Population-Level Evaluation of Emergency General Surgery Models of Care and Clinical Outcomes"],"prefix":"10.1001","volume":"161","author":[{"given":"Jordan","family":"Nantais","sequence":"first","affiliation":[{"name":"Li Ka Shing Knowledge Institute, St Michael\u2019s Hospital, Toronto, Ontario, Canada"},{"name":"Section of General Surgery, Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada"},{"name":"Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Refik","family":"Saskin","sequence":"additional","affiliation":[{"name":"ICES, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Calzavara","sequence":"additional","affiliation":[{"name":"ICES, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Gomez","sequence":"additional","affiliation":[{"name":"Li Ka Shing Knowledge Institute, St Michael\u2019s Hospital, Toronto, Ontario, Canada"},{"name":"Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"ICES, Toronto, Ontario, Canada"},{"name":"Department of Surgery, University of Toronto, Toronto, Ontario, Canada"},{"name":"Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy N.","family":"Baxter","sequence":"additional","affiliation":[{"name":"Li Ka Shing Knowledge Institute, St Michael\u2019s Hospital, Toronto, Ontario, Canada"},{"name":"Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"ICES, Toronto, Ontario, Canada"},{"name":"Department of Surgery, University of Toronto, Toronto, Ontario, Canada"},{"name":"Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"2","key":"soi250092r1","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1097\/TA.0000000000000362","article-title":"The public health burden of emergency general surgery in the United States: a 10-year analysis of the Nationwide Inpatient Sample\u20142001 to 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