{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T04:47:34Z","timestamp":1767156454357,"version":"3.40.5"},"reference-count":18,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,7,11]],"date-time":"2023-07-11T00:00:00Z","timestamp":1689033600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Australian J Rural Health"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective(s)<\/jats:title><jats:p>Life and limb threatening vascular emergencies often present to rural hospitals where only general surgery services are available. It is known that Australian rural general surgical centres encounter 10\u201320 emergency vascular surgery procedures annually. This study aimed to assess rural general surgeons' confidence managing emergent vascular procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting, Participants and Design<\/jats:title><jats:p>A survey was distributed to Australian rural general surgeons to determine their confidence (Yes\/No) in performing emergent vascular procedures including limb revascularisation, revising arterio\u2010venous (AV) fistulas, open repair of ruptured abdominal aortic aneurysm (AAA), superior mesenteric artery (SMA)\/coeliac embolectomy, limb embolectomy, vascular access catheter insertion and limb amputation (digit, forefoot, below knee and above knee). Confidence level was compared with surgeon demographics and training. Variables were compared using univariate logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixteen per cent (67\/410) of all Australian rural general surgeons responded to the survey. Increased age, years since fellowship and training prior to 1995 (when separation of Australian vascular and general surgery occurred) were associated with greater confidence in limb revascularisation, revising AV fistulas, open repair of ruptured AAA, SMA\/coeliac embolectomy, and limb embolectomy (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Surgeons who completed &gt;6\u2009months of vascular surgery training were more comfortable with SMA\/coeliac embolectomy (49% vs. 17%, <jats:italic>p<\/jats:italic>\u2009=\u20090.01) and limb embolectomy (59% vs. 28%, <jats:italic>p<\/jats:italic>\u2009=\u20090.02). Confidence in performing limb amputation was similar across surgeon demographics and training (<jats:italic>p<\/jats:italic>\u2009&gt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Recently graduated rural general surgeons do not feel confident in managing vascular emergencies. Additional vascular surgery training should be considered as part of general surgical training and rural general surgical fellowships.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajr.13014","type":"journal-article","created":{"date-parts":[[2023,7,12]],"date-time":"2023-07-12T04:35:17Z","timestamp":1689136517000},"page":"897-905","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Rural general surgeon confidence with managing vascular emergencies: A national survey"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5888-7391","authenticated-orcid":false,"given":"Jessica A.","family":"Paynter","sequence":"first","affiliation":[{"name":"Department of General Surgery Bendigo Health  Bendigo Victoria Australia"},{"name":"Monash University School of Rural Health Bendigo  Bendigo Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5215-5985","authenticated-orcid":false,"given":"Kirby R.","family":"Qin","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Monash University  Clayton Victoria Australia"},{"name":"Department of Urology Bendigo Health  Bendigo Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0225-9211","authenticated-orcid":false,"given":"Andrew","family":"O'Brien","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Ottawa  Ottawa Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4068-3240","authenticated-orcid":false,"given":"Belinda G.","family":"O'Sullivan","sequence":"additional","affiliation":[{"name":"Monash University School of Rural Health Bendigo  Bendigo Victoria Australia"},{"name":"The Rural Clinical School, Faculty of Medicine University of Queensland  Toowoomba Queensland Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5245-5259","authenticated-orcid":false,"given":"Hasanga","family":"Jayasekera","sequence":"additional","affiliation":[{"name":"Department of General Surgery Bendigo Health  Bendigo Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0470-2734","authenticated-orcid":false,"given":"Janelle","family":"Brennan","sequence":"additional","affiliation":[{"name":"Monash University School of Rural Health Bendigo  Bendigo Victoria Australia"},{"name":"Department of Urology Bendigo Health  Bendigo Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,7,11]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.16068"},{"volume-title":"Modified Monash model","year":"2021","author":"Australian Government Department of Health and Aged Care","key":"e_1_2_12_3_1"},{"volume-title":"Health workforce data tool [Internet]","year":"2020","author":"Australian Government Department of Health and Aged Care","key":"e_1_2_12_4_1"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.14680"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2012.05.023"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-2197.2010.05593.x"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2008.08.034"},{"key":"e_1_2_12_9_1","first-page":"1","volume-title":"How can we improve the decision to transfer patients from regional or rural hospitals? [Internet]","author":"Lennox AWB","year":"2019"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.suc.2020.06.004"},{"volume-title":"General surgery 2016 factsheet 2016","year":"2017","author":"Australian Government Department of Health and Aged Care","key":"e_1_2_12_11_1"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2005.11.024"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1308\/003588413X13511609956778"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2016.10.097"},{"key":"e_1_2_12_15_1","first-page":"31","volume-title":"Train for rural. Rural health equity strategy April 2021 [Internet]","author":"Royal Australasian College of Surgeons","year":"2021"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.14878"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/15266028211028215"},{"volume-title":"General Surgery Curriculum [Internet]","year":"2016","author":"General Surgery Australia","key":"e_1_2_12_18_1"},{"volume-title":"PFET program in rural surgery. [Internet]","year":"2022","author":"General Surgeons Australia","key":"e_1_2_12_19_1"}],"container-title":["Australian Journal of Rural Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ajr.13014","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,4]],"date-time":"2024-01-04T18:01:52Z","timestamp":1704391312000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ajr.13014"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,11]]},"references-count":18,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023,10]]}},"alternative-id":["10.1111\/ajr.13014"],"URL":"https:\/\/doi.org\/10.1111\/ajr.13014","archive":["Portico"],"relation":{},"ISSN":["1038-5282","1440-1584"],"issn-type":[{"type":"print","value":"1038-5282"},{"type":"electronic","value":"1440-1584"}],"subject":[],"published":{"date-parts":[[2023,7,11]]},"assertion":[{"value":"2022-09-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-06-27","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-07-11","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}