{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T15:45:56Z","timestamp":1779378356918,"version":"3.53.1"},"reference-count":29,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2015,7,24]],"date-time":"2015-07-24T00:00:00Z","timestamp":1437696000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2016,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The acute surgical unit (<jats:styled-content style=\"fixed-case\">ASU<\/jats:styled-content>) is a recently established model of care in <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>ustralasia and worldwide. Limited data are available regarding its effect on the management of small bowel obstruction. We compared the management of small bowel obstruction before and after introduction of <jats:styled-content style=\"fixed-case\">ASU<\/jats:styled-content> at a major tertiary referral centre. We hypothesized that introduction of <jats:styled-content style=\"fixed-case\">ASU<\/jats:styled-content> would correlate with improved patient outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review of prospectively maintained databases was performed over two separate 2\u2010year periods, before and after the introduction of <jats:styled-content style=\"fixed-case\">ASU<\/jats:styled-content>. Data collected included demographics, co\u2010morbidity status, use of water\u2010soluble contrast agent and computed tomography. Outcome measures included surgical intervention, time to surgery, hospital length of stay, complications, 30\u2010day readmissions, use of total parenteral nutrition, intensive care unit admissions and overall mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Total emergency admissions to the <jats:styled-content style=\"fixed-case\">ASU<\/jats:styled-content> increased from 2640 to 4575 between the two time periods. A total of 481 cases were identified (225 prior and 256 after introduction of <jats:styled-content style=\"fixed-case\">ASU<\/jats:styled-content>). Mortality decreased from 5.8% to 2.0% (<jats:italic>P<\/jats:italic> = 0.03), which remained significant after controlling for confounders with multivariate analysis (odds ratio = 0.24, 95% confidence interval 0.08\u20130.73, <jats:italic>P<\/jats:italic> = 0.012). The proportion of surgically managed patients increased (20.9% versus 32.0%, <jats:italic>P<\/jats:italic> = 0.003) and more operations were performed within 5 days from presentation (76.6% versus 91.5%, <jats:italic>P<\/jats:italic> = 0.02). Fewer patients received water\u2010soluble contrast agent (27.1% versus 18.4%, <jats:italic>P<\/jats:italic> = 0.02), but more patients were investigated with a computed tomography (70.7% versus 79.7%, <jats:italic>P<\/jats:italic> = 0.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The <jats:styled-content style=\"fixed-case\">ASU<\/jats:styled-content> model of care resulted in decreased mortality, shorter time to intervention and increased surgical management. Overall complications rate and length of stay did not change.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.13238","type":"journal-article","created":{"date-parts":[[2015,7,24]],"date-time":"2015-07-24T10:51:07Z","timestamp":1437735067000},"page":"831-835","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Impact of introduction of an acute surgical unit on management and outcomes of small bowel obstruction"],"prefix":"10.1111","volume":"86","author":[{"given":"Anton M.","family":"Musiienko","sequence":"first","affiliation":[{"name":"Department of General Surgical Specialties The Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rose","family":"Shakerian","sequence":"additional","affiliation":[{"name":"Department of General Surgical Specialties The Royal Melbourne Hospital  Melbourne Victoria Australia"},{"name":"Department of Surgery The University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Gorelik","sequence":"additional","affiliation":[{"name":"The Melbourne EpiCentre The Royal Melbourne Hospital The University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin N. 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